2012-01-03-15 Ureterocele, obstructive ©Fabrice Cuillier www.thefetus.net
Department of Gynecology, Félix Guyon’Hospital, 97400 Saint-Denis, Ile de la Réunion, France.
This 22-year-old woman, G3P2, (90Kg, 155 cm), was referred to our antenatal unit at 30 weeks for a second opinion. There was no known family history of congenital disease and no urology pathology in particular. The patient did not take any medications.
Our ultrasound investigation revealed dysplastic left kidney enlargement with moderate bilateral pyelectasis (Figure 1, 2, 3). The cortico-medullary differentiation seemed present. Inside the bladder, we could see a left-sided cystic structure (12 mm), suggesting a left ureterocele (Figure 4, 5, 6, 7). The amniotic fluid and fetal growth were normal. The diagnosis was confirmed at 31 weeks.
Image 1, 2, 3 : 31 weeks; bilateral pyelectasis.
Image 4, 5, 6, and 7: 31 weeks and a left ureterocele:
Two weeks later, the fetal findings changed and we noted increased right kidney dilatation (Figure 8, 9). The size of the left ureterocele increased as well (14 mm) with left ureteral dilatation. We also suspected a duplicated left system (Figure 10, 11, 12).
Image 8, 9: 33 weeks, right kidney dilatation
Image 10, 11, 12: 33 weeks, a duplicate left system
The amniotic fluid was normal. The patient delivered at 38 weeks. The postnatal diagnosis confirmed the urological pathology. The left ureterocele of the baby was operated on day 8. A few days later, a renal sonography revealed normal kidney, with normal cortico-medullary differentiation.