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Ureteritis Cystica

Definition of Ureteritis Cystica

Ureteritis cystica is a rare urothelial inflammatory response, which causes vesicles of the ureteral mucosa [fig. ureteritis cystica].

Fig. ureteritis cystica: benign inflammatory reaction of the urothelium to infection or mechanical irritation.

Etiology and Pathology

Ureteritis cystica is an inflammatory reaction of the urothelium to infection or mechanical irritation (e.g. nephrolithiasis). The reaction forms subepithelial vesicles of 1 mm to 2 cm in size. The vesicles have an epithelial lining and an inflammatory infiltrate around the cysts, which are filled with protein-rich liquid.

Signs and Symptoms of Ureteritis Cystica

Ureteritis cystica may be without any complains. Possible symptoms are hematuria, urinary obstruction with flank pain, symptoms of a urinary tract infection or symptoms due to nephrolithiasis.

Diagnostic Work-up

• Ultrasound: Hydronephrosis?
• Intravenous or retrograde pyelogram: multiple, round, well-defined, small filling defects of the ureteral wall.
• Ureteroscopy with biopsies: only necessary, when in doubt to confirm the diagnosis.

Treatment of Ureteritis Cystica

The treatment depends on the symptoms: watchful waiting, antibiotic treatment or destruction of the vesicles by ureteroscopy in case of urinary obstruction.

References

  Deutsche Version: Ureteritis cystica