PMC6038490_01
Preoperative (a, b, c) and postoperative (d, e, f) comparison of computed tomography (CT) scans. Preoperative triphasic CT scan images. (a) Contrast-infused axial images of the pelvis demonstrating two large bilateral intravesical cavities. (b) Axial delayed-phase images of the pelvis confirming the diagnosis of bilateral ureteroceles. (c) Coronal delayed-phase images of the pelvis provide another view of the bilateral ureteroceles. Postoperative triphasic CT scan images. (d) Contrast-infused axial images of the pelvis demonstrating the absence of intravesical cavities. (e) Axial delayed-phase images of the pelvis confirming the absence of any residual ureteroceles. (f) Coronal delayed-phase images of the pelvis.
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To rule out duplex system, a triphasic CT-urogram was ordered and it confirmed the patient's bilateral single-system ureteroceles (Figures 1(a)-1(c)). Repeat CT-urogram demonstrated resolution of her bilateral ureteroceles without any signs of ureteral stricture, nor hydronephrosis (Figures 1(d)-1(f)).
Endoscopic images during transurethral resection of bilateral ureteroceles. (a) View from the bladder neck of the left ureterocele with bullous edematous mucosa that was prolapsing. (b) After unroofing of the left ureterocele, the internal left ureteral orifice was cannulated with a hybrid nitinol-PTFE guidewire. (c) A ureteral catheter was placed over the guidewire. (d) Image of the left bladder trigone after complete resection of the left ureterocele. BN: bladder neck. UO: ureteric orifice. Ur: ureterocele wall.
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She was offered transurethral "unroofing" of her ureteroceles with placement of bilateral indwelling ureteral stents to reduce risk of ureteral obstruction postoperatively (Figure 2). As soon as we unroofed the ureterocele, we identified the normal ureteral orifice and placed ureteral catheter over a guidewire (Figure 2).