If reflux is present into the ectopic ureter, ureterectomy is also necessary. If significant vesicoureteral reflux is present into the lower pole of a duplex kidney, ureterocystoneostomy of the lower pole ureter is necessary. [urology-textbook.com]

We present a case of a patient with a known solitary right kidney (congenital absence of a left kidney) presenting with lower urinary tract symptoms, absence of urinary incontinence, and feeling of bulge in the vagina. [ncbi.nlm.nih.gov]

• Enuresis

  Google Scholar | Crossref | Medline Zoller G., Zappel H., Ringert RH Ektopic ureter—a not considered cause of persisting enuresis in girls. Klin Padiatr. 2001 ;213: 314 - 316. [doi.org]

  She received medical therapy including imipramine, anticholinergics, desmopressin and used alarm devices for diagnosis of enuresis nocturna but, could not be cured. There was no history of trauma or pelvic operation. [nzma.org.nz]

  The ectopic ureteral insertion at the proximal third of the vagina, distal to bladder neck and external sphincter, causes urinary incontinence and enuresis in childhood. [jbsr.be]

  Ectopic ureter a not considered cause of persisting enuresis in girls. Klin Padiatr. 2001; 213 :314–6. [ PubMed ] [ncbi.nlm.nih.gov]

  It occurs in young girls with enuresis with slow and interrupted stream and recurrent urinary infection. [patient.info]

• Surgical Procedure

  Both patients went on to have curative surgical procedures. [ncbi.nlm.nih.gov]

  Surgical Procedures for Sphincteric Incontinence in the Male The Artificial Genitourinary Sphincter and Perineal Sling Procedures 427 Urothelial Tumors of the Bladder 432 NonMuscleInvasive Bladder Cancer Ta T1 and CIS 441 Management of Metastatic and [books.google.ro]

  Hence, subsequent surgical procedures have to be kept in mind while deciding the surgery in children with bilateral single system ectopic ureter. [afrjpaedsurg.org]

  In our case, considering the tumorous ureter anastomosis in the prostatic right lobe, and the absence of an ureteral orifice in the prostatic urethra in endoscopy, the surgical procedure was limited to a right hemi-nephro-ureterectomy without associated [jmedicalcasereports.biomedcentral.com]

• Swelling

  Swelling The ureter and part of the kidney can swell when it cannot drain properly. This is called hydronephrosis and it is easy to see on ultrasound. In many babies, an ectopic ureter is found when the pregnant mother has a prenatal ultrasound. [urologyhealth.org]

  A bladder X-ray, called a voiding cystourethrogram (VCUG) is often taken to rule out vesicoureteral reflux, when urine flows backward from the bladder, as the cause for swelling of the kidney and ureter. [childrensnational.org]

  In embryos of 60 mm. head-foot length this becomes raised up in toto and forms the unpaired scrotal swelling, into which the two genital swellings, which we now must term the scrotal swellings, extend from above. [embryology.med.unsw.edu.au]

  Urine that does not properly drain from the kidney can backflow ( vesicoureteral reflux ), placing extra stress and pressure on the kidney and causing increased swelling known as hydronephrosis. [urologists.org]

• Recurrent Urinary Tract Infection

  Signs and Symptoms of an Ectopic Ureter Recurrent urinary tract infections, flank pain, fever. [urology-textbook.com]

  Ureteral anomalies should be suspected in children with an episode of pyelonephritis or recurrent urinary tract infections. [merckmanuals.com]

  A three-year-old female child presented with incontinence, recurrent urinary tract infection and fever since birth. In spite of total incontinence, she had a normal voiding pattern after toilet training. [afrjpaedsurg.org]

  Case Report An eight year old girl presented with the history of persistent dribbling of urine and recurrent urinary tract infections. She had never voided with stream on her own. There was no history of any bowel irregularities. [jpma.org.pk]

• Turkish

  Türk Üroloji Dergisi/Turkish Journal of Urology. 2015; 41(1): 53–55. DOI: https://doi.org/10.5152/tud.2014.81567 Berrocal, T, López-Pereira, P, Arjonilla, A and Gutiérrez, J. [jbsr.be]

  Turkish Journal of Urology. 1999; 25 :109–11. 9. Kibar Y, Avcı A, Akay O, Dayanç M. Dribbling of urine due to ectopic vaginal insertion of an upper pole ureter diagnosed by magnetic resonance urography. [ncbi.nlm.nih.gov]

• Pneumonia

  Initial diagnostics revealed a progressive pneumonia, an intramural ectopic left ureter, and left-sided hydroureter and hydronephrosis. The ectopic ureter was corrected via a ureteral transposition, and the animal recovered well from the procedure. [ecommons.cornell.edu]

• Prolapse

  However, patients with congenital solitary kidney presenting with vaginal prolapse should raise the suspicion for other associated genitourinary anomalies, whether these anomalies are related to the prolapse or not. [ncbi.nlm.nih.gov]

   Prolapsed ureterocele, ectopic perineal ureteral orifice in a child with H/O continuous dampness  Dilated Gartner duct cyst- rare.  Palpable dilated upper pole of ectopic ureter or ureterocele in a relaxed infant. 30. [slideshare.net]

  In rare instances, the ureterocele may prolapse beyond the bladder neck, causing a bladder outlet obstruction. In girls, this may manifest as an interlabial mass. Click here for Patient Education [merckmanuals.com]

  Ureteroceles in boys may prolapse and occasionally obstruct the urethra, but this is very rare. [emedicine.medscape.com]

• Suggestibility

  We present the case of a 3.5-year-old girl who presented with continuous urinary leakage and a classic history suggesting an ectopic ureter, but an inconclusive physical examination and normal imaging by ultrasonography. [ncbi.nlm.nih.gov]

  […] will find dysplasia, thus suggesting that nephrectomy as first choice procedure is not entirely justified[6]. [jpss.eu]

  A duplex renal system, ectopic ureterocele location, or preoperative reflux suggests trigonal anatomic distortion, increasing the likelihood of a secondary operation after puncture. [11] A study by Haddad et al found that the "watering can" endoscopic [emedicine.medscape.com]

  The cystic and ureteral content showed high signal on T1-weighted images (Figure 2C) and low signal on T2-weighted images (Figures 2A and 2B) suggestive of rich proteinaceous material. [appliedradiology.com]

• Irritability

  Abstract PURPOSE: Intestinal metaplasia of the urothelium occurs in chronically irritated retained urinary segments and can progress to enteric adenocarcinoma. [ncbi.nlm.nih.gov]

  After weaning, the breeder may notice that the puppy is frequently wet and sticky, and the skin may become irritated from contact with urine. Sometimes the condition is not identified until the puppy goes to its new home and housetraining begins. [grca.org]

  During years was treated for stress incontinence and irritative bladder. Complete duplication of pelvis and urethra ending in vagina was discover during endoscopy and X ray studies. Upper partial nephrectomy and ureterectomy was performed. [medigraphic.com]

  […] discomfort, infection, vaginal discharge, hydrocolpos, epididymo-orchitis, painful intercourse, ejaculatory pain, prostatitis, seminal vesiculitis, hemospermia, change in bowel habits, and masses of the abdomen, rectum, urethra, and vagina. [2,3,9] Irritative [medscape.com]

  Contracture of the bladder neck This is a common cause of reflux, bladder diverticula and irritable bladder. [patient.info]

• Incontinence

  [permanent dead link] ^ "Diagnosis Of Ectopic Ureter As A Cause Of Urinary Incontinence". Retrieved 2009-02-10. ^ "Duplicated Collecting System". Retrieved 2009-02-10. ^ Schmoldt A, Benthe HF, Haberland G (1975). [en.wikipedia.org]

  In these cases, incontinence is frequent. We present the cases of five female patients treated in our hospital for urinary incontinence due to ureteral ectopia and duplicity. [analesdepediatria.org]

  METHODS: SSEU combined with dysplastic kidney is a rare cause of female incontinence. We retrospectively analyzed 45 pediatric SSEU patients that underwent simple nephrectomy at our institution during 1996-2013 for incontinence. [ncbi.nlm.nih.gov]

• Urinary Incontinence

  […] the urethra or vagina.[3] It can be associated with renal dysplasia,[4] frequent urinary tract infections, and urinary incontinence (usually continuous drip incontinence).[5] Ectopic ureters are found in 1 of every 2000–4000 patients,[6] and can be difficult [en.wikipedia.org]

  We present the case of a patient aged 26 years with a life-long history of persistent urinary incontinence. Initial presentation was at childhood; however, the diagnosis went undetermined for 22 years. [ncbi.nlm.nih.gov]

  Costa, Alvaro PA Furtado, Jose Carlos Fraga Abstract Ectopic ureter draining into the vagina is a rare cause of urinary incontinence. [seer.ufrgs.br]

• Urinary Dribbling

  The significance of the classic history of constant urinary dribbling was not recognized by physicians in 7 girls for 4 months to 7 years 10 months after presentation. [ncbi.nlm.nih.gov]

  Abstract We present 2 patients who had a solitary kidney visualized on ultrasound imaging and experienced constant urinary dribbling. [doi.org]

  "Constant urinary dribbling due to an ectopic ureter and delays in diagnosis". Clin Pediatr (Phila). 46 (6): 544–6. doi:10.1177/0009922807299311. PMID 17579108. ^ "Duplicated Ectopic Ureter" (PDF). Retrieved 2009-02-10. [en.wikipedia.org]

• Hematuria

  Hematuria is not always the revealing sign, since the ureter can be totally obstructed in its insertion [ 3 ]. A CT scan can be limited when it concerns a non-functional kidney or renal dysgenesis. [jmedicalcasereports.biomedcentral.com]

  Of the cases reported in the literature concerning seminal vesicle cyst and ectopic ureter with associated ipsilateral renal agenesis, the characteristic presenting features in postpubertal males are hematuria and epididymal pain with referred pain to [journals.lww.com]

  […] ureters are more common in females and present early with incontinence. 3 The presentation is often delayed in males to early adulthood. 4 The commonly reported symptoms are perineal or pelvic pain, urinary tract infection, prostatitis, epididymitis, hematuria [appliedradiology.com]

  Consequences include infection, hematuria, and obstruction. Stenoses often diminish as the child grows. In primary megaureter, ureteral tapering and reimplantation may be needed when dilation increases or infection or obstruction occurs. [merckmanuals.com]

• Bladder Neck Obstruction

  Contracture of the bladder neck This is a common cause of reflux, bladder diverticula and irritable bladder. [patient.info]

  Bladder neck reconstruction The intent of bladder neck reconstruction in the management of ureterocele is correcting the anatomical abnormalities that are encountered with ureteroceles. [pediatricurologybook.com]

Interestingly 19 of these patients initially had a negative diagnostic workup from a radiologic standpoint. These tests consisted of 15 intravenous pyelograms, 18 VCUGs, 14 ultrasounds, 5 cystoscopies, 1 nuclear VCUG and 1 MRI. [medicalnewstoday.com]

Factors affecting decision for surgical treatment Age of patient Duplicated collecting systems with reflux are expectantly managed with antibiotic suppression until the reflux spontaneously resolves or until the child is older (6-12 months), at which [emedicine.medscape.com]

After imaging studies including CT scan, MRI, or both were done, all the patients underwent laparoscopy for definitive localization and simultaneous treatment. [ncbi.nlm.nih.gov]

Once diagnosed, we are able to move to treatment under the same anesthesia episode. A high percentage of patients respond to treatment and response is often immediate. [vetmed.tennessee.edu]

Diagnostic aspects, such as excretory urography, ultrasonography and helical computed tomography, are being discussed as well as surgical treatment and follow up. [pubblicazioni.unicam.it]

MRI is also useful in the detection of other anomalies e.g. renal duplication, ureterocoele and vertebral anomalies Treatment and prognosis The more distal the insertion, the worse the prognosis. [radiopaedia.org]

With appropriate management, the ultimate prognosis of duplicated ureter, ureteral ectopia, or ureterocele is excellent. Pathophysiology Ureteral embryology is fundamental in understanding abnormal development of the ureter. [emedicine.medscape.com]

However, ectopic ureter is essential for compatibility with life because it preserves the renal function. 7 Because of the associated abnormalities, the successful treatment and long term prognosis are very poor. [jpma.org.pk]

Etiology See etiology of ureteral duplication. Pathology of Ectopic Ureter 80% of ectopic ureters are associated with an ureteral duplication, especially in girls. In boys, the ectopic ureter may also drain a single renal system. [urology-textbook.com]

Epidemiology and Natural History 482 Evaluation and Nonsurgical Management of Benign Prostatic Hyperplasia 486 Minimally Invasive and Endoscopic Management of Benign Prostatic Hyperplasia 493 Retropubic and Suprapubic Open Prostatectomy 496 Epidemiology Etiology [books.google.ro]

Etiology Ectopic ureters are a congenital condition that occur when the embryonic mesonephric and metanephric duct systems do not develop normally. The metanephric duct eventually develops into the ureter. [avmi.net]

Hydronephrosis in renal ectopia: Incidence, etiology and significance. J Urol 1994 ;151:1660–1661. Crossref, Medline, Google Scholar 2. Chung SD, Chueh SC, Chiang HS, Liao CH. L-shaped cross-fused kidney with stone. Urology 2009 ;73:61–62. [liebertpub.com]

[…] demonstrate dilated collecting system, ectopic ureter, ureterocele, and extravesical insertion point of the ectopic ureter, and delineate malformation completely. [ 9, 10 ] Diagnosis of suprasphincteric ureteral opening is made during investigations for the etiology [ncbi.nlm.nih.gov]

Epidemiology 1:2000, more girls than boys. Etiology See etiology of ureteral duplication. Pathology of Ectopic Ureter 80% of ectopic ureters are associated with an ureteral duplication, especially in girls. [urology-textbook.com]

[…] and Natural History 482 Evaluation and Nonsurgical Management of Benign Prostatic Hyperplasia 486 Minimally Invasive and Endoscopic Management of Benign Prostatic Hyperplasia 493 Retropubic and Suprapubic Open Prostatectomy 496 Epidemiology Etiology [books.google.ro]

Epidemiology United States statistics In autopsy series, the incidence of ureteral duplication is estimated at slightly less than 1%. In studies of young children with UTIs, the incidence of duplication rises to 8%. [emedicine.medscape.com]

EPIDEMIOLOGY  Incidence of ureteral duplication- 1% (autopsy series).  Ureteroceles- 1 per 5000-12000 population; 10% bilateral, 60-80% ectopic, 80% a/w upper-pole ureter of a duplex system. [slideshare.net]

Epidemiological analysis of renal dysplasia. Modern Preventive Medicine 2003;11:200. 3. Mackie GG, Stephens FD. Duplex kidneys: A correlation of renal dysplasia with position of the ureteral orifice. J Urol 1975;114:274-80. 4. [jcrsmed.org]

Pathophysiology Urinary incontinence is the most common clinical manifestation of ectopic ureters. [avmi.net]

Cutaneous Continent Urinary Diversion 459 Orthotopic Urinary Diversion 465 Genital and Lower Urinary Tract Trauma 468 Lower Urinary Tract Calculi 471 Development Molecular Biology and Physiology of the Prostate 476 Benign Prostatic Hyperplasia Etiology Pathophysiology [books.google.ro]

Pathophysiology Ureteral embryology is fundamental in understanding abnormal development of the ureter. Ureteral development begins as early as 4 weeks' gestation. [emedicine.medscape.com]

CrossRef PubMed Google Scholar Koff, S.A. (1990) Pathophysiology of ureteropelvic junction obstructions. Urol. Clin. North. Am. 17, 263–272. [link.springer.com]

PATHOPHYSIOLOGY & EMBRYOLOGY Ureteral bud branch from mesonephric/Wolffian duct Extends into nephrogenic blastema(undifferentiated mesenchyma) Formation of the entire renal collecting system Distal to ureteric bud, mesonephric duct incorporates into UGS [slideshare.net]

Understanding the pathogenesis may help develop preventive and renal preservation strategies. The Sonic hedgehog gene and bone morphogenetic protein 4 play crucial roles in preventing anomalies of the ureters and the external genitalia. [ncbi.nlm.nih.gov]

In infants, the small bladder can limit surgical reconstruction with regard to creating a ureteral tunnel that is long enough to prevent recurrent reflux. [emedicine.medscape.com]

To prevent infection, the patient may be put on a low dose of antibiotics before surgery. The 3 types of surgery to fix this problem are: Nephrectomy Ureteroureterostomy Ureteral reimplantation Each option has pros and cons. [urologyhealth.org]