Ectopic Ureterocele

  • Etiology: renal duplication
  • Weigert Meyer rule
    — Ureter draining lower pole inserts in orthotopic (normal) trigonal position + is prone to reflux
    — Ureter draining upper pole inserts ectopically (abnormaly) medial + inferior to lower pole moiety ureter and frequently ends in ureterocele which can cause obstruction + may insert into vagina or rectum
  • 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 if upper moiety drains into urethra below sphincter, male can develop epididymitis / orchitis

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.