Скачать или смотреть Ectopic ureter; Ureters Does not connect to the bladder in the usual location

ectopic ureter is a congenital anomaly where the ureter does not insert into the bladder at its normal location. Instead, it drains into an abnormal site such as the urethra, vagina, vestibule, or even the uterus. This condition is more common in females and often associated with a duplicated renal collecting system.

🧬 Embryological Basis
During development, the ureteric bud should connect with the trigone of the bladder.

In ectopic ureter cases, the bud migrates abnormally, leading to insertion outside the bladder.

Often linked to duplex kidneys, where one ureter drains the upper pole and the other the lower pole.

🔍 Clinical Features
In Females:
Continuous urinary incontinence despite normal voiding (classic sign)

Recurrent urinary tract infections

Normal bladder function otherwise

In Males:
Less likely to cause incontinence (ectopic ureter usually inserts above the external sphincter)

May present with UTIs, hydronephrosis, or flank pain

🧪 Diagnosis
Ultrasound: May show hydronephrosis or duplex system

Voiding cystourethrogram (VCUG): Rules out reflux

MRI or CT urography: Defines anatomy

Cystoscopy: Direct visualization of ureteral orifices

Renal scan: Assesses function of affected kidney segment

💊 Treatment Options
Approach Indication
Ureteral reimplantation Preserves kidney function; corrects drainage
Heminephrectomy Removes non-functioning upper pole in duplex system
Endoscopic ablation Minimally invasive option in select cases
🧠 Key Points
Always consider ectopic ureter in young girls with persistent wetting despite toilet training.

Early diagnosis prevents renal damage and improves quality of life.



#Ureter