Vesikotilotes

Vesikotilotes is a clinical term describing an atypical form of vesicoureteral reflux that involves abnormal outflow of urine from the bladder through an accessory channel or “tilo” – a small, often congenital, diverticulum that connects to the ureter. The word derives from the Greek root vesikos meaning bladder and tilio meaning small sac or pouch.

The condition is most frequently identified in pediatric patients during evaluation for recurrent urinary tract infections or flank pain. Radiographic studies such as a voiding cystourethrogram or nuclear renal scan reveal a focal bulging of the bladder wall that allows retrograde urine flow into the ureteral orifices. Because the diverticulum provides a low‐pressure pathway, patients may experience intermittent hematuria or irritative urinary symptoms.

Management depends on the severity of reflux and the degree of obstruction at the diverticular outlet. Mild cases can be monitored with watchful waiting or prophylactic antibiotics to prevent infection. Surgical intervention, typically endoscopic ablation of the diverticular tract or laparoscopic excision, is reserved for recurrent infections, significant hydronephrosis, or failure of conservative care. Postoperative follow‑up imaging confirms the success of the procedure and monitors for recurrence.

Research into vesikotilotes has focused on its embryologic origins, which appear to involve failed closure of the vesico‑ureteral primordium, and on improving minimally invasive surgical techniques to preserve bladder function. The condition remains rare but is recognized as a distinct entity within pediatric urology.