Bag-like Ureteral End (Differential Diagnosis as before)

mikt_5a_n.jpg: Drawing of a bladder with two orifices entering the bladder on the left side. The ureter which enters the bladder distally continues into a bag-like structure which ends in the bladder neck. The diagnosis is a prolapsing ureterocele in complete ureteral duplication. The involved ureter of the cranial renal part (upper pole) leads to an obstruction of the upper and lower urinary tract, in the latter localization at the level of the bladder neck. mikt_5b_n.jpg: Operative finding in a 1-year-old girl after opening the bladder. Ther is a rounded prominence in the trigonum which is canulated with a ureter catheter directed to the top and left side of the patient. The diagnosis is an analogous case of an ectopic ureterocele. The orifice of the caudal ureter is not depicted. mikt_5c_n.jpg: Cystoscopic findings in a 6.9-year-old boy; parts of a rounded prominence on the right and left side of the patient !£mikt_5c_p£!(pictures to the left or to the right at the top and at the bottom). mikt_5a_n.jpg to mikt_5c_n.jpg: All pictures show a ureterocele which may lead to voiding disorders due to its extension to or into the bladder neck; these are examples of bladder neck stenoses due to an intrinsic obstruction. The diagnosis in the last case is a large bilateral ureterocele of the right and left single ureter (= orthotopic ureterocele). In small orthotopic ureteroceles which lie strictly in the bladder, obstruction of the upper urinary tract with recurrent urinary tract infection stands in the foreground of clinical presentation. In this case report a voiding disorder is also possible due to the large size of the ureterocele.