Ureterocele (ICD-10 - Q62) is a narrowing of the anatomical cavity of the ureter, leading to the formation of a hernia-like formation. As a rule, this pathology is congenital. The acquired form of the disease occurs due to blockage of the urinary canal with a bezoar stone.
Etiology, pathogenesis and clinic
Also, doctors identify the following reasons that contribute to the development of ureterocele (ICD-10 code - Q62 - has already been indicated earlier):
- congenital features of the development of the ureter;
- abnormal lengthening of the ureter segment;
- weakness of the muscle fibers of the organ;
- stone formation;
- hydronephrosis;
- violation of the epithelial layer of the bladder;
- urine outflow disorder;
- impaired mobility of the lower ureter.
Ureterocele can develop in children whose mother suffered during pregnancy such diseases as:
- rubella;
- toxoplasmosis.
The presence of bad habits in the mother during the prenatal periodthe formation of organ rudiments in a child leads to pathology. The initial symptoms of the development of a bladder ureterocele do not have pronounced manifestations. With further progression of the disease, symptoms of ureterohydronephrosis occur. The severe degree of the disease is characterized by urinary incontinence of an involuntary nature. The clinical picture of the disease is characterized by the appearance of the following symptoms of ureterocele in men:
- Acute pains localized in the lower abdomen and kidneys.
- Difficulty urinating.
- The appearance of symptoms of renal colic. Occur in the urinary tract, have a paroxysmal character. If you experience this symptom, you should immediately go to the hospital for emergency medical care.
- An increase in body temperature to subfebrile is the body's reaction to the accumulation of urine and the development of inflammation in the organs of urination.
- Pain during the act of urination.
- Hematuria.
- Exacerbation of chronic diseases of the genitourinary system.
- The presence of an unpleasant smell of discharge, intermittent claudication. The latter occurs due to the pathological development of the formation and pinching of large vessels.
- Changes the color of urine and the nature of the discharge. The patient's urine is dark in color with a persistent unpleasant odor.
It should also be noted that fluid accumulates in the cavity of the uretocele, which is excreted during urination with secretions such as pus, blood, mucus. If untreated, the patient may develop urosepsis, as well as pyelonephritis.
Reasons
Medics still do not have a single opinion about what can be the main cause that contributes to the appearance of a ureterocele of the ureter. However, there is detailed information about exactly what factors can lead to the formation of such a pathology.
So, what can contribute to the development of ureterocele?
Provoke such a pathology can be severe and prolonged poisoning with some chemicals, for example, at work, where you have to breathe harmful vapors of any compounds. as well as excessive alcohol consumption and nicotine intoxication. Various infectious diseases, such as toxoplasmosis or rubella, can contribute to creating a “favorable” environment for such a disease.
Long-term use of hormonal drugs and drugs against tuberculosis increases the risk of ureterocele, in addition, various pathologies that disrupt the excretion of urine from the body can also pose a danger. As soon as the fluid begins to accumulate in the body, it gradually stagnates and turns into an excellent breeding ground for various pathogenic bacteria, naturally, this leads to further formation of pus.
Symptoms
The most common and rather characteristic signs of ureterocele formation that occur in patients is the appearance of characteristic symptoms for thispathology:
- The appearance of acute or aching pain in the kidney area with migration down the abdomen or to the perineum.
- Restriction of the volume of the bladder, which leads to a frequent symptom of impaired urination; 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 act of urination.
- Persistent aching pain in the lower back.
- Protruded ureterocele 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 increase.
- Permanent recurrent urinary tract infections (chronic cystitis, pyelonephritis).
- Pyuria - discharge of pus in the urine.
- Hematuria is the discharge of blood in the urine.
Classification
There is still no generally accepted classification of ureterocele. Urologists distinguish the following types of pathology:
- Ectopic ureterocele. In such a 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 it happens outside, and in boysprolapse 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. In 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 degeneration of muscle fibers in the segment of the ureter, impaired transmission of a nerve impulse in the bladder, stenosis of the ureteral orifice, lengthening of the intramural section. All this can happen in the fetal development of the child. The cause of a congenital anomaly may be diseases that the mother suffered during pregnancy. For example, rubella, herpes and other pathologies of an infectious nature. Also, alcohol abuse, smoking, uncontrolled use of medicines by the expectant mother can lead to congenital anomalies in the fetus.
- Acquired ureterocele. The reason is blockage of the mouth of the ureter due to stone formation in the kidneys and their movement.
Localization
According to the localization of the ureterocele process is:
- Intravesical. The ureterocele is located in the bladder. The most common pathology.
- Extravesical. A bulge occurs when the ureter moves into the genital area or urethra. This location of the pathology is often combined with doublingureter.
Current
According to the degree of flow, ureterocele is also distinguished. This is:
- First degree. In this case, there is a slight expansion of the ureter, functional changes in the kidney are not observed.
- Second degree. The dilation of the ureter leads to the accumulation of urine and the formation of ureterohydronephrosis.
- Third degree. In addition to the accumulation of urine, there is a pathology of the bladder, its functions are disturbed.
Liquid
Ureterocele is distinguished by the type of fluid accumulated in the cyst:
- purulent;
- watery;
- bloody.
The doctor will determine the type of disease after an ultrasound scan for ureterocele. It will show the picture of the disease as much as possible.
Treatments
There are several ways to treat a ureterocele, but only the doctor prescribes the most optimal treatment process after determining the size of the cyst and the type of disease. In addition, when drawing up an individual plan, the physician 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 disease or reduce some symptoms, for example, burning sensation.
To obtain the maximum effect, only surgical treatment is prescribed, in which the cyst is removed after dissection of the ureter. In especially advanced cases, the patient is referred for abdominal surgery, during which the cyst is removed.large sizes. At the earliest stages of the development of such a pathology, a physician can also apply cystoscopic obliteration, however, the treatment plan includes not only surgical treatment, but also a special diet, which the patient must adhere to for a certain time.
Surgical treatment
In no case should you delay the treatment of this disease, as a violation of urine output can lead to further destructive changes in the organs of the urinary system. Removal of the ureterocele 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 alternative treatment
If symptoms have been identified and a diagnosis of urosepsis disease has been made, it is almost impossible to manage with conservative methods of treatment alone. Antibacterial prophylaxis can only be prescribed to a born child if he has been diagnosed with this disease in order to prevent the development of a urinary infection. If there are symptoms of the disease, the patient is immediately prescribed a fairly strong antibiotic therapy and the issue of an immediate operation is decided in order to completely rid the person of the ureterocele.
All possible methods of healing by folk methods are aimed only at reducing or completely relieving pain associated with the disease. For this, the patient may be prescribed herbal preparations that have a diuretic effect. Nothing is impossibletake without prior consultation with a urologist. He will prescribe the right treatment, based on individual characteristics and the patient's possible intolerance to the components.
Ureterocele is not a disease that can be treated with traditional 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 one of the congenital ones. It looks like this: a bulge appears in the inside of the bladder, which is somewhat reminiscent of a hernia, in the form of a ball. The area inside the bubble itself stretches quite a lot due to the fact that a lot of fluid accumulates in it.
Based on this, the best and truly effective method of treatment is a surgical operation, not a single folk 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 only help relieve yourself of severe pain for a while. It may turn out that all of the above methods will contribute to the worsening of the course of the disease.
