Hu Changchang, Han LuYang, Ding Tian, Cao Zhu, Jin Hangmei, Wang Yinfeng
Women's Hospital, Zhejiang University School of Medicine, No. 1 Xueshi Road, Hangzhou, 310006, Zhejiang, People's Republic of China.
BMC Urol. 2025 Jul 3;25(1):152. doi: 10.1186/s12894-025-01842-3.
A ureterocele is a cystic dilatation of the terminal ureter that can be located entirely within the bladder or extend into the urethra. In rare cases, female patients may present with a vaginal mass due to prolapse of an ectopic ureterocele and experience urinary incontinence due to laxity of the external urinary sphincter.
A 37-year-old female presented with a one-year history of recurrent urinary symptoms, including frequent urination, urgency, and dysuria. Over the past two months, she noticed a prolapsed vulvar mass accompanied by urinary incontinence. Three weeks prior to admission, she underwent tension-free vaginal tape-obturator (TVT-O) surgery at another hospital for presumed stress urinary incontinence (SUI). Three days ago, the vulvar mass increased to the size of an egg and could not be manually reduced, accompanied by straining during voiding. Ultrasound and MRI revealed bilateral ureteroceles, with the left ureterocele prolapsed from the bladder to the urethral opening. A diagnosis of ureterocele prolapse with incarceration was made, and the patient underwent manual reduction followed by cystoscopic resection of the left ureterocele. Two days postoperatively, she developed acute pyelonephritis, which was successfully treated with antibiotics.
Prolapsed ureteroceles are a rare condition, and their symptoms can mimic those of SUI, which is typically treated with midurethral sling procedures. However, this treatment approach may inadvertently result in an incarcerated prolapsed ureterocele, requiring urgent medical intervention. This case emphasizes the critical importance of accurate diagnosis of ureteroceles to avoid inappropriate application of midurethral slings and highlights the need for vigilance regarding the potential development of acute pyelonephritis following ureterocele resection.
输尿管囊肿是输尿管末端的囊性扩张，可完全位于膀胱内或延伸至尿道。在罕见情况下，女性患者可能因异位输尿管囊肿脱垂而出现阴道肿物，并因尿道外括约肌松弛而出现尿失禁。
一名37岁女性有一年复发性泌尿系统症状病史，包括尿频、尿急和尿痛。在过去两个月里，她注意到有一个脱垂的外阴肿物并伴有尿失禁。入院前三周，她在另一家医院接受了无张力阴道吊带闭孔术（TVT-O），推测为压力性尿失禁（SUI）。三天前，外阴肿物增大到鸡蛋大小，无法手动还纳，排尿时伴有用力。超声和磁共振成像显示双侧输尿管囊肿，左侧输尿管囊肿从膀胱脱垂至尿道外口。诊断为输尿管囊肿脱垂伴嵌顿，患者接受了手动还纳，随后行膀胱镜下左侧输尿管囊肿切除术。术后两天，她发生了急性肾盂肾炎，经抗生素治疗成功。
脱垂性输尿管囊肿是一种罕见疾病，其症状可类似于SUI，后者通常采用尿道中段吊带手术治疗。然而，这种治疗方法可能会无意中导致输尿管囊肿脱垂嵌顿，需要紧急医疗干预。本病例强调了准确诊断输尿管囊肿以避免不适当应用尿道中段吊带的至关重要性，并突出了对输尿管囊肿切除术后急性肾盂肾炎潜在发展保持警惕的必要性。
