Ureterocele and Ureteral Duplication in Children
A ureterocele is a problem with a
ureter. The ureters are 2 tubes that send urine from the kidneys to the bladder. A
ureterocele is when part of a ureter right near the bladder becomes larger and bulges.
This happens because the ureter’s opening into the bladder is too small and blocks
flow. This causes urine to back up in the ureter. The ureter then swells with too
Children who have a ureterocele may
also have ureteral duplication. This means having 2 ureters for each kidney instead
ureter for each kidney. Each ureter drains into the bladder. The ureter with the
ureterocele often drains urine from the top half of the kidney. The duplicate ureter
drain the lower half. The ureter with the ureterocele may enter the bladder lower
the duplicate ureter. This may cause urine backflow (reflux) into the higher ureter.
Experts don't know what causes ureterocele and ureteral duplication.
But some cases have occurred in siblings. This means a change in a gene may be a
These problems are much more common in girls than in boys. Girls
often have a ureterocele in both ureters. In boys often only 1 ureter is affected.
are also more common in whites compared to other races.
These conditions often don't cause
symptoms. They are often first identified on a prenatal ultrasound. But in some
children, they may lead to urinary tract infections (UTIs) in the first few months
life and repeat infections later. UTIs can cause symptoms.
UTI symptoms in babies can include:
- Bad-smelling urine
- Poor feeding
UTI symptoms in children can include:
- Sudden need to urinate
- Need to urinate often
- Loss of control of urine (incontinence)
- Pain while urinating
- Trouble urinating
- Pain above the pubic bone
- Blood in the urine
- Bad-smelling urine
- Nausea and vomiting
- Pain in the back or side below the ribs
The symptoms can seem like other
health conditions. Take your child to see their healthcare provider for a diagnosis.
A ureterocele may be first seen on
a prenatal ultrasound, while the baby is still in the uterus. In some cases, it may
be found until the child has a UTI. Then your child may have tests such as:
of the entire urinary tract.
This imaging test uses sound waves and a
computer to create images of blood vessels, tissues, and organs. The test is used
see internal organs as they work, and to look at blood flow through vessels.
This is a type of X-ray of the urinary tract.
The healthcare provider puts a thin, flexible tube (catheter) in the tube that drains
urine from the bladder to the outside of the body (the urethra). The provider fills
the bladder with a liquid dye. X-ray images are taken as the bladder fills and
empties. The images will show if your child has any reverse flow of urine into the
ureters and kidneys.
When a ureterocele and ureteral duplication are diagnosed, your child's healthcare
provider will likely order a kidney (renal) scan. This is done to see how well the
kidney is working.
Treatment will depend on your child’s symptoms, age, and general health. It will also
depend on how severe the condition is. Your child may be referred to a urologist.
This is a doctor who treats the urinary tract and the male genital tract.
First, a UTI will be treated with
fluids and antibiotic medicines. The healthcare provider will decide if your child
be treated in a hospital and if they need antibiotics given by IV (intravenous) line.
This will be based on your child's age and on how severe the condition is. Children
younger than 2 months old and those who seem sicker will almost always be treated
hospital with IV antibiotics. In other cases antibiotics may be given by mouth. In
cases you may be able to get IV antibiotics at home. Once the UTI is gone, the
ureterocele will be treated.
Treatment of the ureterocele often depends on how much the ureter is blocked. It also
depends on how well the affected kidney is draining. A small ureterocele may not need
treatment if the kidney is working well enough.
But in most cases a child may need
surgery. If the area of the ureter has a lot of urine buildup, it may need to be drained
with surgery. Larger ureteroceles that cause a lot of urine backflow (reflux) into
kidney may need to be removed or fixed with surgery. In some children, the kidney
affected side may be damaged. The surgeon may need to remove part of that kidney.
Talk with your child’s healthcare providers about the risks, benefits, and possible
side effects of all treatments.
If not treated, a ureterocele may cause kidney damage.
When to Call a Healthcare Provider
Call the healthcare provider if your child has:
- Symptoms that don’t get better or that get worse
- New symptoms
- A ureterocele is a problem with a ureter. The ureters are 2 tubes that send urine
from the kidneys to the bladder. A ureterocele is when part of a ureter right near
the bladder becomes larger and bulges.
- Children who have this may also have
ureteral duplication. This means having 2 ureters for each kidney instead of 1 ureter
for each kidney.
- These problems are much more common in girls than in boys.
- These conditions often don't cause symptoms. But in some children, they may lead to
repeat urinary tract infections (UTIs). Symptoms of a UTI can include fever, need
to urinate often, pain, and crying.
- A small ureterocele may not need
treatment if the kidney is working well enough. In other cases, a child may need
Tips to help you get the most from a visit to your child’s healthcare provider:
- Know the reason for the visit and what you want to happen.
- Before your visit, write down questions you want answered.
- At the visit, write down the name of a new diagnosis, and any new medicines, treatments,
or tests. Also write down any new instructions your provider gives you for your child.
- Know why a new medicine or treatment is prescribed and how it will help your child.
Also know what the side effects are.
- Ask if your child’s condition can be treated in other ways.
- Know why a test or procedure is recommended and what the results could mean.
- Know what to expect if your child does not take the medicine or have the test or procedure.
- If your child has a follow-up appointment, write down the date, time, and purpose
for that visit.
- Know how you can contact your child’s provider after office hours. This is important
if your child becomes ill and you have questions or need advice.