What is a 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 urine flow. This causes urine to back up in the ureter. The ureter then swells with too much urine.
Children who have a ureterocele may also have ureteral duplication. This means having 2 ureters for each kidney instead of 1 ureter for each kidney. Each ureter drains into the bladder. The ureter with the ureterocele usually drains urine from the top half of the kidney. The duplicate ureter may drain the lower half. The ureter with the ureterocele may enter the bladder lower than the duplicate ureter. This may cause a backflow of urine into the higher ureter.
What causes ureterocele and ureteral duplication in a child?
The cause of ureterocele and ureteral duplication is not known. But some cases have occurred in siblings. This means a change in a gene may be a cause.
Which children are at risk for ureterocele and ureteral duplication?
These problems are much more common in girls than in boys. Girls often have a ureterocele in both ureters. In boys often only one ureter is affected.
What are the symptoms of ureterocele and ureteral duplication in a child?
These conditions often don't cause symptoms. But in some children they may lead to repeat urinary tract infections (UTIs). 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. Make sure your child sees his or her healthcare provider for a diagnosis.
How is ureterocele and ureteral duplication diagnosed in a child?
A ureterocele may be first seen on a prenatal ultrasound, while the baby is still in the uterus. In some cases, it may not be found until the child has repeat UTIs. Then your child may have tests such as:
- Ultrasound 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 to view internal organs as they work, and to look at blood flow through vessels.
- Voiding cystourethrogram (VCUG). 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.
How is ureterocele and ureteral duplication treated in a child?
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 may be treated with IV (intravenous) fluids and antibiotic medicines. Once the infection 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.
In other 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 the kidney may need to be removed or repaired with surgery. In some children, the kidney of the 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.
What are possible complications of ureterocele and ureteral duplication in a child?
If not treated, a ureterocele may cause kidney damage.
When should I call my child’s healthcare provider?
Call the healthcare provider if your child has:
- Symptoms that don’t get better or that get worse
- New symptoms
Key points about ureterocele and ureteral duplication in a child
- 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 a ureterocele 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.
- Treatment of the ureterocele often depends on how severe the condition is. A small ureterocele may not need treatment if the kidney is working well enough. In other cases, a child may need surgery.
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.