INTEGRATED CARE FOR URETEROCELE PROLAPSE

Ureteroceles are rare congenital anomalies, occurring in about 1 in 4000 individuals, with a higher incidence in females, particularly those with a duplex renal system. The etiology and clinical presentation of ureteroceles vary, often complicating diagnosis and management. Common symptoms include antenatal hydronephrosis, vesicoureteral reflux (VUR), and recurrent urinary tract infections (UTIs). In cases of ectopic ureteroceles, there is a risk of significant complications, such as hypertension and renal failure, requiring timely and precise intervention. Diagnostic methods include sonography and voiding cystourethrography (VCUG), while management approaches range from minimally invasive endoscopic incisions to more complex excision and reimplantation procedures, depending on the severity. We report the case of a 1.5-month-old female infant, born via LSCS, presenting with fever and a rapidly enlarging reddish mass descending from the urethra. Initially the size of a peanut, it grew to the size of a lemon, accompanied by symptoms of straining during urination and defecation. While prenatal scans showed hydro-ureteronephrosis, postnatal imaging appeared normal until the mass emerged. Clinical suspicion of a ureterocele was confirmed through imaging studies. This case highlights the unpredictable nature of ureteroceles, emphasizing the importance of prenatal and postnatal screening. Treatment strategies must be individualized, considering the rapid progression of the condition. While endoscopic incision is favored for its minimally invasive approach, reconstructive surgery may be necessary if complications such as reflux or a duplex renal system are present. Early detection remains key to preventing long-term morbidity and improving outcomes in infants with ureteroceles.