At Children’s Hospital Boston, we understand that a diagnosis of a ureterocele comes with lot of questions, such as:
- What is it?
- What are the treatments?
- How will it affect my child in the long term?
We’ve provided some answers to these questions below, and when you meet with our experts, we can talk with you more about your child’s specific situation.
What is a ureterocele?
A ureterocele is a small pouch or swelling at the end of your child’s ureter. Normally, the urine flows freely from the kidney to the bladder, but a ureterocele can block part or all of the stream, sometimes even causing the urine to flow backward into your child’s kidney. How much the urinary flow is affected and whether the kidney is at risk of being damaged will indicate how severe your child’s condition is.
Are all ureteroceles the same?
No. Ureteroceles vary widely in terms of severity and location. Some ureteroceles can be virtually nonexistent while others can take up the entire bladder. The severity of a ureterocele depends on its size and the subsequent degree of obstruction it causes.
Mild: A small ureterocele (the most common type) will only minimally affect the flow of urine between your child’s kidney and bladder. Her doctor may choose to simply continue to observe her to make sure the condition doesn’t worsen.
- Severe:A larger ureterocele can lead to more severe blockage of the flow of urine. This can cause problems such as urinary tract infections, vesicoureteral reflux and even kidney damage.
What causes ureteroceles?
The exact reason why a child develops a ureterocele is not known. This congenital (existing at birth; not acquired) condition is often discovered during a routine prenatal ultrasound, which indicates that they arise from problems in the development of your child’s urinary tract and how the ureter inserts into the bladder.
The condition does run in families, so researchers assume there is a genetic component, but specific genes have not been isolated.
Signs and symptoms
What are the symptoms of a ureterocele?
Small ureteroceles only minimally obstruct the flow of urine, so most children with ureteroceles won’t have any symptoms.
Larger ureteroceles can cause a variety of symptoms; by far the most common is a urinary tract infection(UTI).
Common symptoms of UTI in children include:
- pain or burning with urination
- strong or foul odor to the urine
- sudden onset of frequent urination
- enuresis (wetting during the day and night)
A large ureterocele can also cause one or more of the following symptoms in your child:
- a bulge in the abdomen area (if the ureterocele is obstructing urine from leaving the bladder)
- blood in the urine
- failure to thrive
- abdominal pain
- pelvic pain
- difficulty urinating
- recurrent UTIs
Are there any other complications associated with ureteroceles?
A ureterocele can put your child at risk for the following complications:
- vesicoureteral reflux (VUR)— a condition in which the urine flows from the bladder back up toward the kidneys. VUR can predispose a child to developing kidney infections and kidney damage.
- hydronephrosis— a condition in which the backup of urine causes the kidney to swell.
- less commonly, a ureterocele may contribute to the formation of kidney stones.
If left untreated or misdiagnosed, a large ureterocele can damage your child’s kidneys and urinary system. Chronic reflux of urine into the kidney, infection and obstruction can result in irreversible kidney damage that may require a surgical removal of a piece of the kidney called a nephrectomy.
- That’s why it’s vital to see a specialist in urology for an accurate, timely diagnosis.
What is the long-term outlook for my child?
If your child has a large ureterocele that puts her kidney at risk, it may be necessary to perform surgery to avoid permanent kidney damage. But even the most severe ureteroceles can be effectively treated if detected early. With an accurate diagnosis, appropriate treatment and conscientious management, your child should go on to achieve normal urinary function.
Questions to ask your doctor
You and your family are key players in your child’s medical care. It’s important that you share your observations and ideas with your child’s health care provider, and that you understand your provider’s recommendations.
If you’ve made an appointment to talk to a doctor, you probably already have some ideas and questions on your mind. But at the appointment, it can be easy to forget the questions you wanted to ask. It’s often helpful to jot them down ahead of time so that you can leave the appointment feeling that you have the information you need.
Some of the questions you may want to ask include:
- What are our treatment options?
- Are antibiotics safe to take for long time?
- Will my child have to have surgery?
- What types of surgery are possible?
- What’s the recovery process like?
- How long will my child have to stay in the hospital?
- What is the long-term outlook for my child?