Obstructed kidney due to prolapsed ischemic ureterocele in old age female: a case report
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Abstract
Background: Ureteroceles are congenital dilations of the distal ureter, usually diagnosed in childhood. Adult presentations are uncommon, and ischemic prolapse through the urethra is exceedingly rare, particularly in elderly women. Early diagnosis is essential to prevent obstruction, infection, or renal impairment.
Case presentation: A 72-year-old woman presented with severe right loin pain, vomiting, and a recent episode of gross hematuria. Imaging showed right hydronephrosis and a dilated ureter without calculi. A necrotic cystic mass protruding from the urethra was discovered during cystoscopy, consistent with an ischemic prolapsed ureterocele. Aspiration allowed reduction of the mass into the bladder. Endoscopic deroofing of the right ureterocele was performed using a monopolar TUR system, followed by bilateral ureteroscopy, which confirmed unobstructed ureters. The patient recovered well, with normalization of renal function and complete resolution of hydronephrosis. Follow-up cystography and flexible cystoscopy at three months showed no residual ureterocele or vesicoureteral reflux.
Conclusion: Ischemic prolapsed ureterocele in adults is exceptionally rare. Endoscopic deroofing is a safe and effective treatment, even in elderly patients, with favorable functional outcomes.
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