[Orthotopic bilateral ureterocele. Obstructive urination syndrome in a young adult caused by bladder neck occlusion. Differential diagnoses].

OBJECTIVE

To report a case of bilateral orthotopic ureterocele in a 22-year-old male who presented a sudden cessation of urinary stream due to bladder neck obstruction caused by a large, intravesical ureterocele. The differential diagnosis of voiding syndrome and the current approach to ureteroceles are discussed.

METHODS

The literature is reviewed with special reference to the clinical and radiological findings. The nomenclature recommended by the Section on Urology of the American Academy of Pediatrics is utilized, which classifies ureteroceles as intravesical (located entirely within the bladder) or ectopic (if any portion of the ureterocele is located permanently at the bladder neck or in the urethra).

RESULTS/

CONCLUSIONS

Bilateral orthotopic ureterocele is an uncommon pathology. Much less common is a simple occlusion of the bladder neck by a non-prolapsing intravesical ureterocele, as in the case described herein. The prolapse is more common with ectopic ureterocele but can also occur with intravesical ureterocele. We believe that a conservative endoscopic procedure in patients with an intravesical ureterocele reduces the need for major open surgery. However, patients with an ectopic ureterocele require open surgery more frequently. Performing endoscopic puncture initially, facilitates subsequent open surgery.