Ureterocoele calculi masquerading as multiple vesical calculi with acute presentation: a case report

Abstract

Ureterocele refers to the cystic intramural ureteral out-pouching with variable presentation. Ureterocoele calculi are a recognised complication. In this case report, a patient presented acutely with this pathology. Other complications are urosepsis and uraemia. The ureterocele calculi can be unilateral or bilateral. It may be asymptomatic, requiring a high index of suspicion to diagnose, or symptomatic, and may masquerade as multiple vesical calculi during clinical evaluation. In asymptomatic patients with ureterocele calculi, symptoms may supervene due to stone impaction. This is a case report of a patient with single-system orthotopic ureterocele calculi and an impacted calculus manifesting with severe episodic and colicky suprapubic pain unabated by combined analgesic management. The patient had emergency bladder exploration, right-sided orthotopic ureterocele deroofing, and stone evacuation with complete symptom resolution. This case highlights the importance of early consideration of a computerised tomography (CT) scan, if available and affordable, to minimise the diagnostic dilemma of urinary stone diseases and the relevance of ureterocele deroofing in selected patients based on clinical presentation.