Endoscopic incision of protruding right ureterocele in a single collecting system: a case report

Rinto Hariwibowo, Harrina E. Rahardjo



DOI: http://dx.doi.org/10.13181/mji.v25i4.1352

Abstract


Protruding ureterocele is a very rare case found in the literature. We are reporting a 21 year-old female with an intermittent protruding mass from urethra, accompanied by dysuria, hematuria, and recurrent urinary tract infection. Inspection of the external genitalia revealed a protruding mass from the urethra which could be reduced manually. Excretory urography showed bilateral single collecting systems, grade II hydronephrosis of the right kidney, and a cobra head appearance of the lower right pelvis. The patient was diagnosed with a protruding right ureterocele in a single collecting system, and thus, endoscopic incision of a ureterocele was performed. Ultrasonography which was carried out three weeks after the procedure confirmed no residual hydronephrosis or ureterocele in the bladder. Voiding cystourethrography (VCUG) underwent at a three-month-follow up revealed a grade 5 vesico-ureteral reflux (VUR) on the right side. Surgical reimplantation was then considered. In conclusion, endoscopic incision was safe and yielded good result for protruding ureteroceles, but the need for secondary surgery in several conditions should be considered.

Keywords


endoscopic incision; protruding ureterocele

Full Text:

PDF

References


  1. Peters CA, Schlussel RN, Mendelsohn C. Ectopic ureter, ureterocele, and ureteral anomalies. In: Kavoussi LR, Novick AC, Partin AW, Peters CA, editors. Campbell-Walsh urology. 10th ed. Philadelphia: Elsevier Saunders; 2012. p. 3236–60. https://doi.org/10.1016/B978-1-4160-6911-9.00121-3
  2. Kogan BA. Disorders of the ureter & ureteropelvic junction. In: Tanagho EA, McAninch JW, editors. Smith's general urology. 17th ed. New York: McGraw-Hill; 2008. p. 560–2.
  3. Tekgül S, Dogan HS, Erdem E, Hoebeke P, Kočvara R, Nijman JM, et al. Guidelines on paediatric urology. Eur Assoc Urol. 2014. p.90–4.
  4. Zerin JM, Baker DR, Casale JA. Single-system ureteroceles in infants and children: imaging features. Pediatr Radiol. 2000;30(3):139–46. https://doi.org/10.1007/s002470050032
  5. Scovell JM, Chan RC, Khavari R. Prolapse of a single system large ureterocele containing multiple stones in a pregnant woman. Urology. 2014;83(3):e3–4. https://doi.org/10.1016/j.urology.2013.11.021
  6. Muhammed A, Hussaini MY, Ahmad B, Hyacinth MN, Garba KD. Ureteroceles in adults: management of patients in Zaria, Nigeria. Arch Int Surg. 2012;2(1):24–8. https://doi.org/10.4103/2278-9596.101262
  7. Ilica AT, Kocaoğlu M, Bulakbaşi N, Sürer I, Tayfun C. Prolapsing ectopic ureterocele presenting as a vulval mass in a newborn girl. Diagn Interv Radiol. 2008;14(1):33–4.
  8. Konami T, Wakabayashi Y, Takeuchi H, Tomoyoshi T. Female wide urethra masquerading as a urethral diverticulum in association with ectopic ureterocele. Hinyokika Kiyo. 1988;34(8):1437–41.
  9. Waihenya CG. Prolapsed single system ureterocele in a female adult: case report. East Afr Med J. 2008;85(4):197–200. https://doi.org/10.4314/eamj.v85i4.9644
  10. Vijay MK, Vijay P, Dutta A, Gupta A, Tiwari P, Kumar S, et al. The safety and efficacy of endoscopic incision of orthotopic ureterocele in adult. Saudi J Kidney Dis Transpl. 2011;22(6):1169–74.
  11. Timberlake MD, Corbett ST. Minimally invasive techniques for management of the ureterocele and ectopic ureter: upper tract versus lower tract approach. Urol Clin N Am. 2015;42(1):61–76. https://doi.org/10.1016/j.ucl.2014.09.006
  12. Sen I, Onaran M, Tokgoz H, Tan MO, Biri H, Bozkirli I. Prolapse of a simple ureterocele presenting as a vulval mass in a woman. Int J Urol. 2006;13(4):447–8. https://doi.org/10.1111/j.1442-2042.2006.01336.x
  13. Westesson KE, Goldman HB. Prolapse of a single-system ureterocele causing urinary retention in an adult woman. Int Urogynecol J. 2013;24(10):1761–3. https://doi.org/10.1007/s00192-012-2040-4





Copyright (c) 2017 Rinto Hariwibowo, Harrina E. Rahardjo

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

All articles and issues in Medical Journal of Indonesia have unique DOI number registered in Crossref.
 
Romeo
 
http://mji.ui.ac.id/journal/index.php/mji/pages/view/stat
Unique Visitors