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Correct Answer - D
Ans. D: Ureterocele
The term ureterocele denotes a cystic ballooning of the distal end of the ureter.
This type of ureterocele is also termed orthotopic, since it
arises from a ureter with a normal insertion into the trigone.
An intravesical ureterocele results from the prolapse of the mucosa
of the terminal segment of the ureter through the ureterovesical
orifice into the bladder.
This prolapsed ureteral mucosa carries with it a portion of the
continuous sheet of the bladder mucosa around the orifice.
The prolapsed segment thus has a wall that consists of a thin layer of
muscle and collagen interposed between the bladder uroepithelium
and the ureter uroepithelium.
Since the terminal ureteral orifice is usually narrowed and partially
obstructed, and since there is no muscle support for the double
mucosal walls of the prolapsed segment, it dilates.
This dilated segment fills with urine and protrudes into the bladder.
On excretory urography, cobra head sign is classically seen with an
intravesical ureterocele.
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