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Virtual Pediatric Hospital: Paediapaedia: Ureterocele, Ectopic Paediapaedia: Genitourinary Diseases

Ureterocele, Ectopic

Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed

Clinical Presentation:
Most commonly presents as a urinary tract infection. A palpable abdominal mass may be present. Older children may complain of dysuria. Females may complain of incontinence or prolapse while males may present with epididymo-orchitis.

Balloon like dilation of the terminal ureter. There are two types, simple and ectopic.

A simple ureterocele arises from a normally positioned single ureter and varies in size and shape as the urine is emitted from a stenotic orifice, and is rarely seen in children because it is an acquired abnormality.

An ectopic ureterocele arises from an ectopic ureter that drains the upper pole segment in a duplex kidney and inserts inferomedially in the bladder in relationship to the normal ureter (Weigert-Meyer rule). In males the ectopic ureter can insert into the bladder, bladder neck, or genital tract (seminal vesicle, ejaculatory duct, vas deferens) while in the female the ectopic ureter can insert in the bladder, or anywhere along the distal urinary tract down to the level of the uterus, cervix and vagina. Fifty percent have vesicoureteral reflux into the ipsilateral ureter and 15% have vesicoureteral reflux into the ureterocele.

Not applicable

Imaging Findings:
Ultrasound of a distended bladder may show the tubular ureterocele within the bladder, and associated hydroureteronephrosis of the upper pole collecting system may also be seen.

An IVP may show the ureterocele as a broad based filling defect in the bladder.

VCUG may show reflux.


See References Chapter.

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