Which congenital condition is described as obstruction of the ureteric orifice with hyperechoic septation seen within the bladder at the ureteric orifice?

• A. Ureterocele
• B. Bladder diverticulum
• C. Urethral duplication
• D. Bladder neck obstruction

Answer: (A)

This describes a ureterocele. It’s a congenital dilation of the intravesical portion of the distal ureter caused by obstruction at the ureteric orifice as it enters the bladder. On ultrasound, you’d see a round, cystic structure within the bladder right at the expected ureteric orifice. The hyperechoic septation inside the cystic structure reflects internal folds or mucosal lining of the dilated ureter, which can give that bright, partition-like appearance. Ureteroceles can cause downstream urinary obstruction and may be associated with a duplex collecting system.

Bladder diverticulum would appear as an outpouching of the bladder wall with a neck connecting to the bladder lumen, not a discrete intravesical cyst at the ureteric orifice. Urethral duplication involves a second urethral channel, not a cystic lesion at the bladder outlet. Bladder neck obstruction is an outlet problem at the bladder neck, not a lesion at the ureteric orifice.