Ureterectasis · What Is It, Causes, Treatment, and More

Published: Nov 20, 2025

Author: Anna Hernández, MD•

Editor: Alyssa Haag, MD•

Editor: Ian Mannarino, MD, MBA•

Editor: Kelsey LaFayette, DNP, RN, FNP-C•

Editor: Anna Hernández, MD •

Editor: Mary Roberts, MSN, RN

Illustrator: Jessica Reynolds, MS•

Copyeditor: Stacy L. Johnson, LMSW

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What is ureterectasis?

Ureterectasis refers to the dilation of one or both ureters, which are the fibromuscular tubes that carry urine from the renal pelvis of the kidneys to the urinary bladder. If there’s an obstruction to the flow of urine, it can cause pressures in the ureters to increase, thereby causing dilation. With dilation of just the ureter, it is called ureterectasis, or hydroureter. If there is dilation of the ureter and respective kidney, it’s called hydroureteronephrosis or hydronephrosis.

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What causes ureterectasis?

Causes of ureterectasis can be divided into congenital and acquired causes.

Congenital causes include UPJ, or ureteropelvic junction obstruction, a birth defect where the ureteropelvic junction (i.e., the area that connects the ureter to the kidney) fails to canalize during fetal development, obstructing the flow of urine. Another congenital cause is vesicoureteral reflux, where urine flows backward from the bladder into the ureters and, eventually, the kidneys. Congenital causes also include posterior urethral valves, where the posterior urethra, which is the section of the urethra nearest to the bladder, is obstructed by flaps of tissue.

On the other hand, acquired causes of ureterectasis include kidney stones, prostatic hyperplasia (i.e., enlarged prostate), and external compression of the ureter by retroperitoneal or pelvic tumors.

How is ureterectasis diagnosed?

Often, ureterectasis is asymptomatic and discovered incidentally on an ultrasound or other imaging (e.g., CT scan).

How is ureterectasis treated?

Ureterectasis treatment aims to relieve the obstruction and allow the urine that may have accumulated behind the obstruction to flow out. In cases of ureteropelvic junction obstruction, treatment may involve a pyeloplasty, a surgical remake of the renal pelvis. In the case of posterior urethral valves, treatment may involve surgery and ablation of the membrane of tissue, which allows urine to flow to the bladder unobstructed. Lower urinary tract obstructions, like kidney stones, may be treated with shockwave lithotripsy or surgery and stent placement. Finally, prostatic hyperplasia can be managed by inserting a urinary catheter to keep the urethra open or a suprapubic catheter to allow bladder decompression. Definitive treatment of prostatic hyperplasia with obstructive symptoms usually involves surgery to reduce the size of the prostate.

What are the most important facts to know about ureterectasis?

Ureterectasis refers to the dilation of one or both ureters, the tubes that carry urine from the kidneys to the bladder. Causes can be congenital, such as ureteropelvic junction obstruction, vesicoureteral reflux, or posterior urethral valves, or acquired, such as kidney stones, prostate enlargement, or external compression from nearby tumors. Many people with ureterectasis do not have noticeable symptoms, and the condition is often found incidentally on imaging. Diagnosis is usually made through ultrasound or CT imaging, which shows the dilation of the ureter. Treatment focuses on relieving the obstruction and restoring normal urine flow. Depending on the cause, management may include surgical correction (e.g., pyeloplasty for a ureteropelvic junction obstruction), removal of obstructions (e.g., stones), or relieving pressure through catheterization or stenting.

Key Takeaways

Definition	Ureterectasis refers to the dilation of one or both ureters.
Causes	- Congenital causes - Ureteropelvic junction obstruction (UPJ) - Vesicoureteral reflux - Posterior urethral valves - Acquired causes - Kidney stones - Prostatic hyperplasia - External compression of ureter by retroperitoneal or pelvic tumors
Diagnosis	- Asymptomatic - Incidental finding on ultrasound or other imaging
Treatment	- UPJ → pyeloplasty - Posterior urethral valves → surgery and ablation of the membrane of tissue - Lower urinary tract obstruction (e.g., kidney stones) → shockwave lithotripsy, surgery, stent placement - Prostatic hyperplasia → urinary or suprapubic catheter, definitive treatment with surgery

References

Davis MF, Zack J, Weiss DA. Posterior urethral valves: Overview of urologic management from the antenatal period to adulthood. Curr Treat Options Pediatr. 2024;11(1). doi:https://doi.org/10.1007/s40746-024-00318-0

Dika Ž, Marić M, Živko M. Treatment of urolithiasis: A comprehensive review. Eur Med J Urol. 2025;13(1):82-97. doi:https://doi.org/10.33590/emjurol/nbza7146

Gaillardetz A, Ohiokpehai J. Benign prostatic hyperplasia: Rapid evidence review. Aafp.org. Accessed June 4, 2025. https://www.aafp.org/pubs/afp/issues/2023/0600/benign-prostatic-hyperplasia.pdf

Läckgren G, Cooper CS, Neveus T, Kirsch AJ. Management of vesicoureteral reflux: What have we learned over the last 20 years? Front Pediatr. 2021;9:650326. doi:https://doi.org/10.3389/fped.2021.650326

Patel K, Batura D. An overview of hydronephrosis in adults. Br J Hosp Med (Lond). 2020;81(1):1-8. doi:https://doi.org/10.12968/hmed.2019.0274