Continued constipation can cause high bladder pressure, reflux, and ureterovesical junction
deformities, predisposing the child to urinary tract infection and even pyelonephritis, Dr.
Cystoscopy evaluation revealed a bilateral diverticulum near ureterovesical junction
(Hutch diverticulum) and multiple calculi in the diverticulum (Fig.
Urethral steinstrasse is uncommon because fragments that pass through the ureterovesical junction
can often traverse a much larger caliber .
Therefore, it is usually bilateral and mostly located at the ureterovesical junction
.[sup.9] As noted previously, it is rate that metastatic tumour from the prostate to the proximal ureter happens without direct extension.
Objective: The urine flow, which is also called ureteric jet, can be demonstrated by Doppler ultrasound at the ureterovesical junction
90% are located superolateral to the ureteral orifice in proximity to the ureterovesical junction
Laparoscopic treatment of ureteral injuries appears to be the method of choice due to its good results.[sup.2] When there is complete injury of the distal ureter, direct ureteral reimplantation or a psoas-bladder or Boari-flap hitch procedure is usually performed to ensure ureterovesical continuity.[sup.1,5] This type of surgical treatment with ureteroneocystostomy often requires ureteral reimplantation to control the physiological function of the ureterovesical junction
,[sup.5] a procedure that extends the operating time and increases morbidity.
After advancement of the ureterorenoscope 2 cm proximal to the ureterovesical junction
, lateral and medial ureter end up in a single chamber.
At the ureterovesical junction
, 3 ureteral segments are distinguished: the juxtavesical, intramural, and submucosal segments.
Her uretero-ileal anastomoses were functioning perfectly; therefore, we wished to avoid a re-implantation and risk stenosis of her new ureterovesical junction
. As well, her ileal conduit was created for a primary indication of incontinence, thus the use of her native detrusor would have required a formal bladder neck procedure.
Contrast enhanced CT of abdomen and pelvis showed one large, heterogeneously-enhanced mass in the prostate, imprinting the bladder base and right ureterovesical junction
, without clear demarcation from the prostate (Fig.
Occasionally, bladder diverticulum may result from congenital disarrangement of muscle fibers, mostly located in the ureterovesical junction
. This is commonly referred to as "Hutch" diverticula.[sup.1] In our case, the latter is the most likely etiology.