Last revised by Mohammad Taghi Niknejad on 19 Jun 2023

Pseudoureterocoeles are acquired dilatations of the submucosal portion of the distal ureter that mimic simple ureteroceles. The appearance of the radiolucent wall surrounding the dilated distal ureteral segment (cobra head sign) is an important differentiating point. 

The distinction is important, since most pseudoureterocoeles were related to malignancy involving the bladder.

In a pseudoureterocoele:

  • the lucency or halo is thicker than that of a uterocele and is poorly defined; in cases of tumors, it may be irregular and may show a filling defect within the ureterocele 
  • there is asymmetry of the dilated ureteral lumen 
  • there is moderate to severe obstruction of the upper tract
  • there is evidence of an acquired cause, such as a calculus or abnormal vesical mucosal pattern
  • rarely, thickening of this lucency in a patient with a known ureterocele is usually associated with a complicating process, such as edema with a calculus

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