Ureterocele (ICD-10 - Q62) is a narrowing of the anatomical cavity of the ureter, leading to the formation of a herniform formation. As a rule, this pathology is congenital in nature. The acquired form of the disease occurs due to blockage of the urinary canal with a bezoar stone.
Etiology, pathogenesis and clinic
Also, doctors distinguish the following reasons that contribute to the development of ureterocele (the code for ICD-10 - Q62 - has already been indicated earlier):
- congenital features of the development of the ureter;
- pathological lengthening of the ureter segment;
- muscle weakness of the organ;
- stone formation;
- hydronephrosis;
- violation of the epithelial layer of the bladder;
- urine outflow disorder;
- violation of the mobility of the lower parts of the ureter.
Ureterocele can develop in children whose mother suffered during pregnancy diseases such as:
The presence of bad habits in the mother during the period of intrauterine formation of the primordium of the organs in the child leads to pathology. The initial symptoms of ureterocele of the bladder do not have pronounced manifestations. With further progression of the disease, symptoms of ureterohydronephrosis occur. A severe degree of the disease is characterized by involuntary urinary incontinence. The clinical picture of the disease is characterized by the appearance of the following symptoms of ureterocele in men:
- Acute pain with localization in the lower abdomen and kidneys.
- Difficulty urinating.
- The onset of symptoms of renal colic. Occur in the urinary tract, have a paroxysmal character. If this symptom occurs, you must immediately go to the hospital for emergency medical care.
- Raising the body temperature to subfebrile is a reaction of the body to the accumulation of urine and the development of inflammation in the organs of urination.
- Pain during urination.
- Hematuria
- Exacerbation of chronic diseases of the genitourinary system.
- The presence of an unpleasant smell of discharge, intermittent claudication. The latter arises due to the pathological development of the formation and pinching of large vessels by it.
- The color of urine and the nature of the discharge changes. The patient's urine is dark in color with a persistent unpleasant odor.
It should also be noted that fluid accumulates in the urethocele cavity, which is excreted during urination with such secretions as pus, blood, and mucus. If untreated, the patient may appear urosepsis, as well as pyelonephritis.
Causes
Doctors still do not have one opinion about what could be the main reason that contributes to the appearance of the ureterocele of the ureter. However, there is detailed information about exactly which factors can lead to the formation of such a pathology.
So, what can contribute to the development of ureterocele?
Such a pathology can be provoked by severe and prolonged poisoning with some chemicals, for example, at work, where you have to breathe harmful vapors of any compounds. The development of such a disease can be most severely affected by the adverse environmental situation in the place of residence, as well as excessive alcohol consumption and nicotine intoxication. Various infectious diseases, such as, for example, toxoplasmosis or rubella, can contribute to creating a “favorable” environment for such a disease.
Long-term use of hormonal drugs and anti-tuberculosis drugs increases the risk of ureterocele, in addition, various pathologies that interfere with the removal of urine from the body can be dangerous. As soon as the liquid begins to accumulate in the body, it gradually stagnates and turns into an excellent environment for the multiplication of various pathogenic bacteria, naturally, this leads to further formation of pus.
Symptoms
The most common and quite characteristic signs of ureterocele formation that are found in patients are the appearance of characteristic symptoms for this pathology:
- The appearance of acute or aching pain in the kidney area with migration down the abdomen or in the perineum.
- The restriction of the volume of the bladder, which leads to frequent symptoms of urinary disorders; with a total violation of the outflow of urine leads to acute hydronephrosis, with an increase in the volume of the kidneys and paroxysmal pain in the lower back.
- Increased urination up to 10-15 times a day, due to the release of urine in small volumes.
- Urine is excreted in small portions.
- Constant feeling of heaviness in the abdomen.
- Pain throughout the course of urination.
- Constant aching lower back pain.
- Ureterocele lobbied during urination (mainly in women).
- Renal colic, which is manifested by sharp pain in the kidneys and groin, with fever, chills, fatigue, nausea, vomiting, asthenia.
- Temperature rise.
- Constant recurrent urinary tract infections (chronic cystitis, pyelonephritis).
- Pyuria - discharge of pus in the urine.
- Hematuria - excretion of blood with urine.
Classification
There is still no universally accepted classification of ureterocele. Urologists distinguish the following types of pathology:
- Ectopic ureterocele. In this case, the protrusion is outside the bladder. Its frequent localization in the neck of the bladder or urethra.
- Prolapsing ureterocele. The formation of a dark purple color goes out or in. In girls, this happens outside, and in boys, prolapse is localized in the urethra, which contributes to the formation of acute urinary retention.
- Simple ureterocele. In turn, it is divided into unilateral and bilateral. With a simple form, a slight expansion of the ureter occurs in the bladder.
Appearance
Due to the occurrence, two types of ureterocele are distinguished, these are:
- Congenital ureterocele. Pathology occurs in connection with the abnormal development of the ureter. Such defects include dystrophy of muscle fibers in the segment of the ureter, impaired transmission of a nerve impulse in the bladder, stenosis of the mouth of the ureter, lengthening of the intramural section. All this can happen in the intrauterine development of the child. The cause of a congenital anomaly can be the diseases that the mother suffered during pregnancy. For example, rubella, herpes and other pathologies of an infectious nature. Also, alcohol abuse, smoking, uncontrolled intake of drugs by the expectant mother can lead to a congenital anomaly in the fetus.
- Acquired ureterocele. The reason is a blockage in the mouth of the ureter due to stone formation in the kidneys and their movement.
Localization
According to the localization of the process, ureterocele is:
- Intravesical. Ureterocele is in the bladder. The most common pathology.
- Bubbly. A protrusion occurs when the ureter moves to the genital area or urethra. This location of the pathology is often combined with a doubling of the ureter.
Flow
Ureterocele is also distinguished by the degree of course. It:
- First degree. In this case, there is a slight expansion of the ureter, functional changes in the kidney are not observed.
- Second degree. The expansion of the ureter leads to the accumulation of urine and the formation of ureterohydronephrosis.
- Third degree. In addition to the accumulation of urine, pathology of the bladder is observed, its functions are disturbed.
Liquid
By the type of fluid that has accumulated in the cyst, a ureterocele is distinguished:
The doctor will establish the type of disease after an ultrasound with ureterocele. It will show the picture of the disease as much as possible.
Treatment methods
There are several ways to treat ureterocele, but the most optimal treatment process is prescribed only by a doctor after determining the size of the cyst and the type of disease. In addition, when drawing up an individual plan, the doctor also takes into account whether there are any concomitant diseases. Treatment with conservative methods is practically not prescribed, since it does not bring the desired effect, with its help you can only stop the development of this ailment or reduce some symptoms, for example, burning.
To obtain the maximum effect, only surgical treatment is prescribed, in which the cyst is removed after the ureter is cut. In especially advanced cases, the patient is sent for abdominal surgery, during which a large cyst is removed. At the very early stages of the development of such a pathology, a physician can also apply cystoscopic obliteration, but the treatment plan includes not only surgical treatment, but also a special diet, which the patient must adhere to for a certain time.
Surgery
In no case should you delay the treatment of this disease, since a violation of urine output can lead to further destructive changes in the organs of the urinary system. Ureterocele removal is the most effective method. In addition, a violation of the outflow of urine can lead to the appearance of stones of different diameters, as well as to the development of any infectious diseases.
Drug and folk treatment
If symptoms have been identified and a diagnosis of urosepsis has been made, it is almost impossible to manage with conservative treatment methods alone. Antibacterial prophylaxis can only be given to a child born if he has been diagnosed with the disease in order to prevent the development of urinary infection. If there are symptoms of the disease, the patient is immediately prescribed a fairly strong antibacterial therapy and the issue of immediate surgery is decided in order to completely rid the person of ureterocele.
All possible methods of healing with alternative methods are aimed only at reducing or completely eliminating the accompanying illness of pain. For this, the patient may be prescribed herbal preparations with a diuretic effect. Nothing can be taken without prior consultation with a urologist. He will prescribe the right treatment, based on individual characteristics and possible intolerance of the components in the patient.
Ureterocele is not a disease that is treated with alternative methods. By itself, treatment with folk remedies will not bring any desired result, since the disease is a deviation in the functioning and development of the urinary system, it is among the congenital. It looks like this: in the inner part of the bladder a bulge appears, which is somewhat reminiscent of a hernia, in the shape of a ball. The area inside the bubble itself is quite stretched due to the fact that a lot of liquid accumulates in it.
Based on this, the best and truly effective method of treatment is a surgical operation, not a single alternative method will help to cope with the disease. It is impossible to cure the disease by taking a variety of pills, drinking a bunch of decoctions and making lotions, all this will help only for a while to relieve yourself of severe pain. It may happen that all of the above methods contribute to the worsening of the course of the disease.