Related Experiment Videos
Abstract:
There have been few reported cases of ureteral diverticula less than 4 mm in diameter; these are best described as pseudodiverticula based on their appearance in specimens obtained for pathologic study. An additional 23 patients are reported, 15 of whom were examined by urinalysis, urine culture, cystoscopy, and cytologic studies of the urine. Cytologic findings are of interest because of previous reports suggesting an association between ureteral diverticula and transitional cell carcinoma in the urinary tract. Hematuria, transitional cell carcinoma, and benign prostatic hyperplasia were the most common presenting conditions. Infection was found in only three. Diverticula were multiple in 91%, bilateral in 69%, and were predominantly upper and midureteral in location. Urine cytologic studies failed to detect early uroepithelial malignancy, but nonspecific cellular atypia and an association with malignancy in 30% of these patients suggests that close follow-up of patients with ureteral pseudodiverticulosis is prudent.
Insights
Small ureteral pseudodiverticula are uncommon. While urine cytology missed early cancers, cellular atypia in patients with ureteral pseudodiverticulosis warrants close follow-up due to potential malignancy.
Area of Science:
- Urology
- Pathology
Background:
- Ureteral diverticula, particularly small ones (<4 mm), are rarely reported and often appear as pseudodiverticula in pathological specimens.
- Previous studies suggest a potential association between ureteral diverticula and transitional cell carcinoma (TCC) of the urinary tract.
Purpose of the Study:
- To report on a series of patients with ureteral pseudodiverticula, focusing on clinical presentation and diagnostic findings.
- To evaluate the utility of urine cytologic studies in detecting malignancy in patients with ureteral pseudodiverticulosis.
Main Methods:
- Retrospective review of 23 patients with ureteral pseudodiverticula.
- Diagnostic workup included urinalysis, urine culture, cystoscopy, and urine cytologic studies in 15 patients.
Main Results:
- The majority of diverticula were multiple (91%), bilateral (69%), and located in the upper/mid-ureter.
- Common presenting conditions included hematuria, transitional cell carcinoma, and benign prostatic hyperplasia.
- Urine cytology failed to detect early uroepithelial malignancy but showed nonspecific cellular atypia in some patients.
Conclusions:
- Ureteral pseudodiverticulosis is frequently associated with malignancy (30% in this series).
- Close patient follow-up is recommended due to the observed association with malignancy and cellular atypia.