Ectopic ureter: A concise narrative review with anatomical and clinical commentaries

Bilateral single system ectopic ureters with bilateral urethral insertion and horseshoes kidneys in a female child

“…The anatomical anomaly may result in retention/obstruction while the anti-reflux failure may develop as a vesicoureteral reflux. 3 The CT-scan for this patient showed that both kidneys were developed (albeit with horseshoes kidneys), and dismembering Lich-gregoir approach may correct the anatomical anomaly and provide an anti-reflux system using the tunnelling technique. Furthermore, by performing the surgery early, we aimed to preserve the bladder function by letting the bladder develop through stimulation by physiological micturition.…”

“…As reported in previous studies, it is suggested that the abnormal uretero-bladder connection in patients with bilateral single-system ectopic ureters is associated with the frequent occurrences of hypoplastic bladder and poorly developed trigone and bladder neck. 2 , 3 , 4 , 5 Continence becomes one main issue, whether the surgery outcome may or may not result in adequate voluntary control of micturition for the patient; should the surgeon perform only ureteral reimplantation, ureteral reimplantation with augmentation and bladder neck reconstruction, or bladder neck closure with continent urinary diversion? 2 …”

A Single-System Ectopic Ureter in a Child: A Challenge for Early Diagnosis

“…If there is preserved renal functionality, studies indicate a preference for nephron-sparing surgery and ureteral reimplantation [ 1 , 4 ]. Our patient underwent excision of the distal portion of the ureter with reimplantation in the bladder trigone.…”

“…The embryological origin of the ectopic ureter is related to the initial position of the ureteral bud in the Wolffian duct and the abnormal development of nephrogenic blastema, which occurs in the fourth week of gestation [ 4 ]. In males, due to the ectopic insertion of the ureter being above the external sphincter, it usually presents with obstructive conditions and urinary infections.…”

“…If the renal segment drained by the ectopic ureter is functional, nephron preservation techniques should be preferred, such as ureteroneocystostomy and ureteroureterostomy. If the segment is not functional, nephroureterectomy can be considered [ 1 , 4 , 5 ].…”