Incarcerated prolapsed ureterocele is an important differential diagnosis for post-surgical vulvar masses

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Frontiers in Medicine Published June 9, 2026 Medically reviewed June 9, 2026 DOI ↗ By Dr. Lars van Dijk, PhD · Surgical, Procedural & Diagnostic

Key Takeaway

Consider incarcerated prolapsed ureterocele in the differential diagnosis of post-surgical vulvar masses with urinary symptoms.

This case report with systematic review explores the clinical presentation and diagnosis of incarcerated prolapsed ureterocele (IPU). The scope includes both a primary case report and 15 cases from existing literature to evaluate IPU as a differential diagnosis for patients presenting with vulvar masses following midurethral sling surgery.

The synthesis indicates that while IPU is an uncommon condition, it is a clinically important differential for interlabial or vulvar masses accompanied by urinary symptoms. Multimodal ultrasonography was noted for its diagnostic utility, specifically in identifying the dumbbell sign and clarifying the relationship between the prolapsed ureterocele and the surgical sling. Surgical management of these cases is generally associated with favorable outcomes.

A primary limitation of this evidence is the small sample size of 16 total cases. Clinical application suggests that IPU should be considered when evaluating postoperative vulvar masses, as imaging is essential for accurate diagnosis. Due to the limited number of reported cases, clinicians should interpret these findings as a specialized diagnostic consideration rather than a common occurrence.

Study Details

Study typeMeta analysis

EvidenceLevel 1

PublishedJun 2026

View Original Abstract ↓

BackgroundIncarcerated prolapsed ureterocele (IPU) after midurethral sling (MUS) surgery is extremely rare and may be misdiagnosed as a vulvar or interlabial mass because of its atypical presentation and altered postoperative anatomy.MethodsWe report the clinical presentation, multimodal ultrasonographic findings, surgical management, and follow-up of a patient with IPU after MUS surgery. A systematic review was conducted in accordance with the PRISMA framework using major medical databases to identify previously reported cases. Fifteen cases were identified from the literature; together with the present case, 16 cases were included in the analysis.ResultsThe patient presented with a vulvar mass after MUS surgery, and the diagnosis was difficult because of altered postoperative pelvic anatomy. Multimodal ultrasonography demonstrated a characteristic dumbbell sign, showing continuity between the intravesical and prolapsed components, and dynamically clarified the relationship between the prolapsed ureterocele and the sling in the postoperative setting. In the 16 included cases, prolapsed ureterocele was an uncommon but important differential diagnosis in women presenting with an interlabial or vulvar mass, especially when accompanied by urinary symptoms. Imaging was essential for diagnosis, and surgical treatment was generally associated with favorable outcomes.ConclusionIPU after MUS surgery is a rare but clinically important condition that should be considered in the differential diagnosis of postoperative vulvar or interlabial masses. Multimodal ultrasonography can provide dynamic assessment of ureterocele anatomy and its relationship to the sling, while CT and MRI remain useful complementary modalities in selected cases.