favourite case of the week - Lyla.
Lyla presented for pollakiuria and stranguria of fairly acute onset. Ultrasound revealed a cystic structure in the region of the trigone that was causing intermittent urinary outflow obstruction.
Ureterocoeles are an uncommon cause of bladder outflow obstruction, especially in this age patient. However, exploratory cystotomy confirmed the diagnosis of a ureterocoele. It was large and protruding into the trigone region of the bladder. It had already been ruptured by the foley catheter, so it was simply a matter of dissecting the walls to create a new opening into the bladder. Distally, bladder mucosa was closed over the resected ectopic ureter.
Lyla recovered well. She is recovering from surgery but also from pyelonephritis which was also likely secondary to the ureterocele.
She is now continent with no urinary outflow obstruction or urinary incontinence. I am seeing her back next week for a recheck.