Ectopia in Unduplicated Ureters in Children

Abstract

The clinico-pathological features and surgical management of 19 unduplicated ectopic ureters in 15 children are presented with special reference to the problems of recognition and treatment and to the underlying embryological and pathological significance of the wide-ranging associated abnormalities. The high incidence of renal and ureteric malformations, both ipsilateral and contralateral, is emphasised, as is also the frequent co-existence of vesical, bladder neck, urethral, genital and anal abnormalities. These associated anomalies modify the presentation of unduplicated ureteric ectopia and may mask its presence. Late recognition is common, but may be avoided by awareness of the problem. Whereas the degree of kidney involvement seems to dictate the choice and priorities of surgical treatment, the lower urinary tract anomalies have more significance as regards continuing disability and these largely determine the outcome in relation to continence.

Bilateral Single System Ectopic Ureters With Ureterocele: A Rare Association in an Adult Male

“…Our patient has agenesis of the left seminal vesicle associated with BSSEU. Bladder neck and trigone are maldeveloped in 75% of BSSEU [1], but spontaneously increased bladder capacity may occur with time [2,4] and patients can achieve normal bladder function [5]. Both these findings are corroborated in this case as this patient had normal bladder function and capacity along with normal voiding and was fully continent.…”

“…BSSEUs are fortunately rare because they present a complex therapeutic problem [1]. In males the ureters usually drain into the prostatic urethra.…”

“…A ureter that opens at a site other than the posterolateral aspect of the trigone is known as ectopic ureter [1]. The bilateral single system ureteral ectopia arises from the cranial origin of the ureteric buds from the mesonephric ducts resulting in delay in their incorporation into the urogenital sinus.…”

Bilateral Single Ureteral Ectopia

“…Kesavan et al [7] have speculated whether the ectopic ureter is a component of a more widespread embryonic field defect and not just ureteral bud maldevelopment. Of 42 cases reported in which clinical information was provided, 6 involved imperforate anus [7][8][9]. Two patients in our series had imperforate anus.…”

Uncommon ureteric ectopias: embryological implications

“…It could integrate the urogenital sinus more distally, resulting in a ureteric opening into the bladder neck, urethra [7,24,44], distal vagina, or vestibule [16,17,24,26,44]. If the ureteric bud remains attached to the mesonephric duct, it leads in boys to an ectopic ureter into the seminal vesicle [7,11,41,44], vas deferens [21,45], or epididymis [35] and in girls into Gartner's duct cysts [40,54].…”