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21 апреля 2025 г.
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URETEROCELE IN COMBINATION WITH UROLITHIASIS:
CLINIC, DIAGNOSIS, AND TREATMENT
Qo’ziyev Sohib Saloyiddin o’g’li
Bukhara Innovative Education and Medical University
.
assistant of the Department of clinical and pre-clinical sciences
Raupov Abdurahmon Ortiq o’g’li
Bukhara Innovative Education and Medical University.
Bukhara .Uzbekistan
.
assistant of the Department
of clinical and pre-clinical science
s
Аnnotation.
The article presents the main aspects of the clinic, diagnosis,
and treatment of ureterocele in combination with urolithiasis. An example from
the author's own clinical practice is provided.
Keywords:
ureterocele, urolithiasis,. urinary tract anomalies, diagnosis,
treatment, endoscopic surgery, ureteral obstruction, kidney stones, urological
complications.
Ureterocele is a developmental defect of the distal ureter walls, characterized
by the enlargement of the intravesical portion, which bulges cyst-like into the
bladder cavity and obstructs urine flow. Ureterocele is a common developmental
anomaly, most frequently observed in women. According to current
understanding, the development of ureterocele is influenced by several factors,
including the vertical angle of the ureter’s insertion into the bladder, shortening of
the submucosal tunnel, stenosis of the ureteral orifice, and thinning of the detrusor
muscle.[1]
Ureterocele can be unilateral or bilateral. According to A.Y. Pytel's
classification, the following types of ureterocele are distinguished: 1) simple
ureterocele, located in a normally positioned ureter. It can be either unilateral or
bilateral; 2) prolapsing ureterocele: in girls, it protrudes through the enlarged
urethra as a dark red formation, sometimes covered with ulcerated mucosa; in
boys, it protrudes into the prostatic part of the urethra, causing acute urinary
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retention. Ectopic ureterocele is located in an abnormally positioned ureter that
opens into the urethra, vaginal vestibule, bladder diverticulum, etc.[2]
Ureterocele can be primary (congenital) or secondary (acquired) in etiology.
E.A. Ostropolskaya distinguishes three degrees of congenital ureterocele. In
degree I, the expansion of the intravesical part of the ureter is relatively small and
does not lead to functional changes in the upper urinary tract. Degree II
ureterocele is larger and leads to the development of ureterohydronephrosis.
Degree III ureterocele is of giant size, causing bilateral ureterohydronephrosis and
significant disturbances in bladder function.[3]
The problem of ureterocele and its associated complications, the most
common of which is urolithiasis, remains relevant to this day. Prolonged
obstruction and urine stasis create an ideal environment for stone formation, and
the addition of a urinary tract infection accelerates this process. The development
of urolithiasis in patients with ureterocele is observed in 15-42% of cases.[4]
The clinical picture of ureterocele is virtually devoid of specific
manifestations, except for the rare cases of ureterocele prolapse. The symptoms
depend on the size of the ureterocele, which determines the degree of urinary
dynamics impairment in the upper and lower urinary tract and the complications
caused by this.[5]
Characteristic manifestations of ureterocele include constant aching pain in
the lumbar and iliac regions, recurrent chronic infections such as cystitis and
pyelonephritis, and painful urination. The diagnosis of ureterocele involves a
comprehensive approach including clinical-laboratory, radiological, ultrasound,
and instrumental examination methods.[5]
Conclusion:
Ureterocele is a congenital or acquired developmental defect in
the distal ureter, leading to cyst-like bulging in the bladder and obstructing urine
flow. It can be unilateral or bilateral, with three degrees of severity based on the
size and functional impact on the urinary tract. The condition is often associated
with complications like urolithiasis, as prolonged obstruction and urine stasis
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promote stone formation. Clinical symptoms are nonspecific but may include
chronic pain, recurrent infections, and painful urination. Diagnosis requires a
comprehensive approach, including clinical, laboratory, radiological, ultrasound,
and instrumental methods. Ureterocele is most commonly observed in women and
may present with varying degrees of severity, from minor functional disruption to
significant kidney and bladder dysfunction.
REFERENCES
1. Урология. Под ред. Лопаткина Н.А. М.: «Медицина», 1995 г, с.110-
114.
2. Трапезникова М.Ф., Соболевский А.Б., Романов Д.В. Оптимальные
методы лечения различных форм уретероцеле. Альманах клинической
медицины. 2002 г., №5. с.101-8.
3. Трудный диагноз в урологии. Под ред. МакКаллаха Д.Л.М.:
«Медицина». 1997 г, с.24-32 .
4. Урология по Дональду Смиту, под ред. Танаго Э., Маканинча Дж. М.,
2005 г, с. 222-32.
5. Долгов А.Г. Современные аспекты диагностики и лечения
уретероцеле в сочетании с уролитиазом, Автореф. 2004 г
