Cecoureterocele Presenting as a Urethral Mass in an Infant Female: A Rare Case Report.

Abstract

Introduction: Cecoureterocele is an uncommon variant of ureterocele characterized by submucosal extension of the ureterocele beyond the bladder neck into the urethra. It is usually associated with duplex collecting systems and is more commonly encountered in pediatric female patients. Clinical manifestations range from asymptomatic hydronephrosis to a prolapsing urethral mass, often posing diagnostic dilemmas.

Case presentation: We report the case of an 8-month-old female who presented with crying during micturition, a narrow urinary stream, and an intermittent prolapsing mass per urethra. Imaging demonstrated bilateral complete duplex collecting systems with left upper moiety gross hydronephrosis. DMSA scan revealed poor function of the left upper moiety. Cystoscopy identified a left ectopic ureteric orifice inferomedially to the native ureteric orifice with a ureterocele protruding into the urethra. Endoscopic decompression via transurethral incision using a Bugbee electrode resulted in immediate decompression. The infant had an uneventful postoperative recovery, with resolution of symptoms and reduced hydronephrosis at 6-month follow-up.

Conclusion: Cecoureterocele, though rare, should be suspected in infants presenting with voiding dysfunction and a urethral mass. Early diagnosis with imaging and minimally invasive decompression via endoscopic incision offers excellent outcomes, preserves renal function, and reduces the need for open surgery.