Ureteral pseudodiverticulosis is acquired false diverticula resulting from herniation of epithelium through the muscularis layer of the ureter and characterized by the presence of multiple outpouchings smaller than 5 mm. It is more commonly bilateral and located in the upper two-thirds of the ureter.
It is relatively uncommon. It is common in men between 40-60 years old.
Most patients are asymptomatic, but some have a history of chronic urinary tract infection or haematuria.
The etiology and clinical significance of ureteral pseudodiverticulosis are not clear, but chronic inflammation and/or obstruction are likely causes.
Histologically, they demonstrate focal hyperplasia of the urothelium protruding into the muscularis.
An association between the presence of ureteral pseudodiverticula and transitional cell carcinoma has been proposed but not confirmed yet.
Multiple bilateral small outpouchings of the ureter involving the proximal two-thirds of the ureter. Infrequently, these findings may be detected on multidetector CT.
Treatment and prognosis
There is no specific treatment indicated in asymptomatic patients; however, due to increased risk of urothelial malignancy in these patients surveillance including cytology and urinalysis in 6 monthly basis or annual cystoscopy is recommended.
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