Full Text Article Open Access

Citation: Al Adimi A, Odaini N. Urinary retention: A rare presentation of adult ureterocele. Jr. med. res. 2023; 6(1):12-14. Al Adimi et al © All rights

are reserved. https://doi.org/10.32512/jmr.6.1.2023/12.14 Submit your manuscript:www.jmedicalresearch.com

Case Report

Al Adimi Abdulelah

, Odaini Nabil

Urinary retention: A rare presentation of adult ureterocele.

1: Department of urology, Al Emadi

Hospital, Doha, Qatar.

* Corresponding author

Correspondence to:

nbilodainil@hotmail.com

Publication Data:

Submitted: November 8,2022

Accepted: December 30,2022

Online: January 31,2023

This article was subject to full

peer-review.

This is an open access article distributed

under the terms of the Creative Commons

Attribution Non-Commercial License 4.0

(CCBY-NC) allowing sharing and adapting.

Share: copy and redistribute the material in

any medium or format.

Adapt: remix, transform, and build upon the

licensed material.

The work provided must be properly cited

and cannot be used for commercial

purpose.

Ureterocele is a rare congenital malformation characterized by pseudo-cystic dilation of the

lower ureter extremity [1]. Ectopic ureteroceles is usually a pediatric entity diagnosed

incidentally or in the investigation of childhood urinary tract infection. Diagnosis in adult age

remains rare. Adult ureterocele is characterized by its clinical polymorphism and manifest

obstructive symptomatology in case of complications. We herein report the case of giant

adult ureterocele responsible of complete urinary retention. The aim was to highlight the

clinical, radiological and endoscopic features of this rare condition.

Keywords

Ureterocele; adult; endoscopy; urine retention.

Introduction

Ureterocele is a congenital cystic dilation of the distal ureter out-pouching into the urinary

bladder. Clinical presentation is nonspecific and polymorph leading sometimes to diagnostic

delay. Adult ureterocele is a rare condition and usually asymptomatic. Management of these

cases is challenging and remains nonconsensual [1].

In this report, we present a successful endoscopic resection of giant ureterocele presenting

with complete urinary retention.

Observation

A 38-Year-old male patient presented to the emergency department with severe lower

abdominal pain and urine retention. foley’s catheter inserted permitted the evacuation of

more than 900cc of urine. Laboratory investigations were normal. Ultrasound of abdomen

and pelvis revealed a huge cystic intravesical lesion obstructing the internal urethral orifice

with left mild hydronephrosis (figure 1). The patient underwent endoscopic resection of the

ureterocele and DJ stent insertion (figure 2,3). The postoperative course was uneventful. The

outpatient follow up revealed no urinary symptoms.

Abstract

Figure1: left ureterocele presenting as huge intravesical cystic mass.

Urinary retention: A rare presentation of adult ureterocele

are reserved. Submit your manuscript: www.jmedicalresearch.com.

Figure 2: ureterocele presenting as huge cystic intravesical lesion obscuring endoscopic vision.

Figure 3: Features after complete endoscopic resection.

Urinary retention: A rare presentation of adult ureterocele

are reserved. Submit your manuscript: www.jmedicalresearch.com.

Conflict of Interest: None

References

[1] Kurokawa T, Kabuto T, Matsuta Y, Aoki Y, Ito H, Yokoyama O, et al.[Adult Male Ureterocele Detected by Urinary Frequency]. Hinyokika Kiyo. 2017 ;63:207-210. Japanese.

[2] Yoshimura A, Yamanaka K, Wakita T, Fukae S, Yoshida T, Kishikawa H. [Ectopic Ureterocele of Adult Male with Urination Difficulty : A Case Report]. Hinyokika Kiyo. 2021; 67:381-84. Japanese.

[3] Atta ON, Alhawari HH, Murshidi MM, Tarawneh E, Murshidi MM. An adult ureterocele complicated by a large stone: A case report. Int J Surg Case Rep. 2018;44:166-71.

[4] Yuri P, Utama ETP. A complete duplicated collecting system with giant ureterocele in adult: Case report. Int J Surg Case Rep. 2021;79:49-52.

[5] Basiri A, Bonakdar Hashemi M, Aslani A. Endoscopic Dilatation of Meatal Stenosis of Ureterocele in Adult Patients: An Easy and Innovative Technique with Literature Review. Urol J. 2020;18:240-46.

Discussion

Pediatric Ureteroceles are frequently diagnosed on antenatal ultrasonography or during investigation of recurrent urinary tract

infection (UTI)[2]. Bladder outlet obstruction is an uncommon presentations of adult ureteroceles and may lead to significant

decline in kidney function [3]. Obstruction of the bladder outlet is commonly caused by prolapse of the ureterocele into the

urethra causing physical obstruction of the bladder neck. Anatomic obstruction of the bladder neck by the cystic ureterocele

may incite obstructive voiding symptoms or may precipitate acute urinary retention in both pediatric and adult populations [4].

Prolapse of the ureterocele and its presentation as a vulval mass is an extremely rare condition in female patients. Ultrasound

examination is useful for diagnosis of the ureterocele and its complications. Endoscopic resection is an effective mini-invasive

technique allowing complete treatment with comfortable postoperative course [5].