0022-5347 /79/1223-0403$0.200/0

THE

Vol. 122, September Printed in U.S.A.

JOURNAL OF UROLOGY

Copyright© 1979 by The Williams & Wilkins Co.

STONES IN ORTHOTOPIC, NON-OBSTRUCTING URETEROCELES EDWARD M. MESSING

AND

STEPHEN C. HENRY*

From the Department of Surgery, Division of Urology, Stanford University Medical Center, Stanford and the Department of Urology, KaiserPermanente Medical Center, Santa Clara, California

ABSTRACT

A case is presented in which stones were found bilaterally in orthotopic, non-obstructing ureteroceles in a child. This is apparently the first reported instance of this condition occurring in the presence of sterile urine. A review of related literature gives clues to the possible etiology of such an occurrence. In children. ureteroceles usually are diagnosed during an investigation for urinary infection, obstruction or incontinence. 1 Herein we report on a boy with an unusual manifestation of this condition. CASE REPORT

A 2½-year-old white boy had gross, total painless hematuria. He had no history of urinary infection, recent upper respiratory infection or antecedent trauma. None of his relatives had known urinary tract disease. Physical examination was normal, including the height and weight for his age. Urinalysis demonstrated a pH of 5, full field red blood cells, occasional white blood cells and no crystals or casts. A urine culture was sterile. Complete blood counts, Creactive protein and complement (C3 and C4) levels were

figure). Cystoscopy confirmed the presence of bilateral orthotopic ureteroceles in an otherwise normal-appearing bladder. At operation the ureteroceles were excised, stones were removed and bilateral ureteroneocystostomy was done. Convalescence was uneventful and a repeat IVP 4 months postopera-' tively was normal. The stones were sterile and were composed of calcium oxalate with trace amounts of uric acid. Subsequent 24-hour urine specimens demonstrated normal excretion of calcium, uric acid and cystine. DISCUSSION

We have been unable to find a similar description of a child with sterile urine and a calculus in an otherwise uncomplicated ureterocele. Authors reporting large series of pediatric patients (204 cases) with ureteroceles described no children with this

A, abdominal x-ray demonstrates calculi in region of ureterovesical junctions. No renal or ureteral stones are visible. B, IVP reveals ureteroceles containing stones.

normal. Antistreptolysin-0 titer was

Stones in orthotopic, non-obstructing ureteroceles.

0022-5347 /79/1223-0403$0.200/0 THE Vol. 122, September Printed in U.S.A. JOURNAL OF UROLOGY Copyright© 1979 by The Williams & Wilkins Co. STONES...
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