title: [Acute urinary retention secondary to giant prolapsed ureterocele in a young adult woman. Case report].
abstract: BACKGROUND
  Ureterocele is a cystic dilation of the distal ureteral segment. The incidence in women ranges from 1/5,000 to 1/12,000. In adults, they are poorly diagnosed and are asymptomatic. Prolapse through the urethra is uncommon, and involves acute urine retention and a reducible vulvar tumour.
  
  
  METHODS
  Woman of 24 years old, two previous caesarean and two abortions. She had incomplete bladder emptying, intermittent voiding, bladder straining and tenesmus, three months before admission. After the voiding effort she presented with acute urine retention with sudden onset of tumour in the vulva. The tumour was manually reduced under regional anaesthesia. A cystoscopy was performed, finding an ischaemic de-roofing of the anterior wall of the ureterocele, causing vesicoureteral reflux grade IV. Surgical correction was performed with Cohen re-implantation and insertion of a double-J catheter. The catheter was removed 30 days later, with a successful post-operative course.
  
  
  CONCLUSIONS
  Its aetiology is unclear, and most are diagnosed by ultrasound in the prenatal period. The clinical presentation is variable, from urinary tract infection to prolapse. Despite its size, it may cause complications such as ischaemic de-roofing, which if diagnosed soon may be resolved successfully, as with this patient.
  
  
  CONCLUSIONS
  The results and treatment may be favourable when no renal impact or concomitant anatomical changes are present, as is the case of this patient.
authors.affiliation: Servicio de Urología, Hospital General Regional No. 36, Instituto Mexicano del Seguro Social. Puebla, México.
authors.forename: Roberto
authors.initials: R
authors.lastname: Villagómez-Camargo
authors.affiliation: Servicio de Urología, Hospital General Regional No. 36, Instituto Mexicano del Seguro Social. Puebla, México.
authors.forename: Marco
authors.initials: M
authors.lastname: Chopin-Gazga
authors.affiliation: Servicio de Urología, Hospital General Regional No. 36, Instituto Mexicano del Seguro Social. Puebla, México.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Saucedo-Bravo
authors.affiliation: Jefatura de División de Investigación en Salud, Unidad Médica de Alta Especialidad, Hospital de Traumatología y Ortopedia Instituto Mexicano del Seguro Social. Puebla, México.
authors.forename: Eugenio
authors.initials: E
authors.lastname: García-Cano
authors.affiliation: Jefatura de División de Investigación en Salud, Unidad Médica de Alta Especialidad, Hospital de Traumatología y Ortopedia Instituto Mexicano del Seguro Social. Puebla, México; Academia Nacional de Educación Médica de México, México. Electronic address: dralmoja@hotmail.com.
authors.forename: Álvaro
authors.initials: Á
authors.lastname: Montiel-Jarquín
mesh_terms: D000208:Acute Disease; D003558:Cystoscopy; D005260:Female; D006801:Humans; D056887:Pelvic Organ Prolapse / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D012092:Replantation; D014513:Ureter / Q000601:surgery; D014518:Ureterocele / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D014546:Urinary Catheterization; D016055:Urinary Retention / Q000209:etiology*; D014718:Vesico-Ureteral Reflux / Q000209:etiology; D055815:Young Adult
keywords: Adult; Adulto; Mujer; Prolapse; Prolapso; Tumor vulvar; Ureterocele; Vulvar tumour; Woman