Ectopic Ureterocele

  • Etiology: renal duplication
  • Weigert Meyer rule
    — Ureter draining upper pole inserts ectopically (abnormally) medial + inferior to lower pole moiety ureter and frequently ends in ureterocele which can cause ureteral obstruction + upper pole hydronephrosis + may insert into urethra or vagina
    — Ureter draining lower pole inserts in orthotopic (normal) trigonal position + is prone to reflux
  • VCUG: filling defect in bladder during early filling phase
  • US: cystic mass in bladder that is hard to see after endoscopic puncture for treatment
  • Clinical: female has constant wetting day and night for as long as anyone can remember if upper moiety drains into urethra below bladder sphincter, male can develop epididymitis / orchitis if they have low ureteral insertion

Radiology Cases of Ectopic Ureterocele

US of duplicated kidney with ectopic ureterocele and hydroureteropyonephrosis
Sagittal US of the right kidney (upper left) shows a duplicated renal collecting system with the upper pole replaced by a round structure filled with echogenic material. Sagittal US of the right upper pole ureter (upper right) shows a tortuous ureter filled with echogenic material. Transverse US of the bladder (lower left) shows a round structure in the right side of the bladder that has echogenic material in its inferior portion and anechoic material in its superior portion. Sagittal US of the right ureter and bladder (lower right) shows the tortuous right ureter filled with echogenic material on the left side of the image and the rounded structure with the fluid-fluid level in the right side of the bladder.

Clinical Cases of Prolapsed Ectopic Ureterocele

Clinical image of prolapsed ectopic ureterocele
Clinical image shows a purple mass protruding from the vagina. On ultrasound the mass was cystic and there was a left-sided duplicated kidney whose upper pole collecting system was extremely dilated.