Ureterocele

Description

Ureterocele is a congenital pathological development of the ureter, an intravesical cyst. Due to its incorrect development. It forms in the wall of the ureter and exfoliates it. The walls of the ureterocele develop from the tissues of the walls of the bladder and ureter.

Appears in the period of fetal formation, leads to thinning in the bladder of the ureteral passage.

The ureterocele acquired develops when the stones move into the bladder cavity from the kidneys. Stones linger in the mouth of the ureter, making it difficult to drain urine.

Disease in boys is observed 3 times less often than in girls. Adult people are rarely ill.

Forms of the disease

Ureterocele happens:

1. Intravesical.
2. Ectopic.

The intravesical is located inside the bladder. Ectopic extends beyond the walls of the bladder.

Ureterocele can be observed:

• in the region of the neck of the bladder;
• in the urethra.

3 degrees are distinguished:

1. At the first, a small expansion of the intravesical part of the ureter is observed.
2. At the second degree, the ureter is enlarged, as well as the renal cavity system.
3. At the third degree, there are significant disorders of the functioning of the bladder.

Reasons for

The main reasons for the development of ureterocele are:

• narrowing( congenital) of the ureteral orifice;
• lengthening of the ureter segment;
• deficiency of the muscular fibers of the ureter;
• infringement of an innervation( supply of organs by nerves) of the bottom department of a ureter and nearby tissues;
• infringement( long) of the urinary stone in the ureter;
• impaired urine outflow;
• delamination of the tissues of the walls of the bladder;
• hydronephrosis( stagnation in the renal pelvis of urine).

Because of the onset, the disease happens:

1. Primary( congenital).There is a slow dissolution of the tissue inside the ureter, which leads to its narrowing, which delays the urine.
2. Secondary( purchased).It develops with infringement of the stone in the mouth of the ureter.

Symptoms of

The most accurate indication of a disease is a disturbed outflow of urine.

The main symptoms of the pathology include:

• traumatic pains in the lumbar region, which is constantly present;
• chronic cystitis or pyelonephritis;
• impurities in pus urine;
• change in the transparency and color of urine;
• feverish conditions;
• is a rather painful procedure for urination;
• rapid urination;
• urinary incontinence or difficulty urinating;
• imperative( mandatory) urge to urinate.

Diagnosis

The pathology is usually found in a urological examination:

1. Urine analysis reveals an increased content of leukocytes, erythrocytes, glucose and protein in the urine and an inflammatory process in the genitourinary system.
2. Bacteriological study gives a picture of the microflora of urinary infections.
3. Ultrasound of the bladder and kidneys reveals the cyst, estimates its size and determines the presence of stones.
4. Cystography and urography reveals changes in the kidneys.
5. Cystoscopy. A method for examining the internal walls of the bladder with a special optical device, identifies a cystic protrusion.
6. Nephroscintigraphy assesses the degree of filtration of substances by the kidneys.
7. Uroflowmetry( determination when urinating the flow rate of urine).The method reveals the type and extent of the urethra disorder during the period of the urethral blockage.

Treatment of

Ureterocele can only be cured by surgery:

1. Ureterocystoneostomy is the main method of surgical intervention. A new hole is created in the bladder. The ureter separates from the bladder, is shortened and is again sewn into the bladder. Transurethral endoscopic dissection of the ureteral orifice. It is carried through the urethra, eliminates the obstruction of excretion from the ureter of urine.
2. Resection( partial removal) of the kidney and ureter with atrophy of the parenchyma of the kidney.
3. Nephrectomy. Kidney removal( complete) with its atrophy. This is done usually laparoscopically or through a small incision in the intercostal space.

Contraindications for the operation:

• failure of the functioning of one kidney or both;
• impaired blood clotting;
• of urinary tract disease, having an infectious nature.

Surgical interventions:

1. Combined prolonged anesthesia, traumatism. After the operation, the outflow of urine takes place through the tubes inserted under the skin.
2. Possible bleeding and other serious complications.
3. The patient should be in the intensive care unit for some time to provide narcotic analgesia and intensive care. Normally, sick people come after the operation for 15-30 days.

If the defect is small, urodynamics is not broken, and pyelonephritis does not manifest itself, then treatment of the disease is not required.

Folk remedies

Treatment of ureterocele with the help of folk remedies is aimed at relieving pain. For this purpose, diuretics from herbs are prescribed. The fee should be agreed with the urologist.

Complications of

Complications of the disease include the following:

• ureter enlargement;
• hydronephrosis( dilated cup and pelvis system);
• stones in the ureterocele and kidney cavity;
• cystitis;
• bleeding from the urinary tract;
• renal atrophy;
• arterial hypertension( high pressure, not amenable to treatment);
• disruption of all kidney function;
• prolapse ureterocele out through the urethra;
• pyelonephritis( inflammation of the bowel-cup system of the kidneys).

Prevention

Prevention of the development of ureterocele is as follows:

1. Timely treatment of infectious diseases of the bladder with the use of antibacterial medicines.
2. With difficulty urinating - an urgent call for a urologist.
3. Compliance with diet. Should reduce the amount of protein and fatty foods, salt. Be sure to observe the drinking regime. To use only easy-assimilated foodstuffs, prepare dishes for a couple.
4. Take antihypertensive drugs( reducing blood pressure).
5. Take antibacterial drugs that help stop the growth or death of bacteria.

The result of treatment of ureterocele depends on the causes of the disease, the age of the patient, the presence of concomitant diseases.