scholarly journals Ultrasonographic and Radiographic Diagnosis of Ectopic Ureter in a Dog

2021 ◽  
Vol 49 ◽  
Author(s):  
Carmen Vládia Soares De Sousa ◽  
Caroline Coelho Rocha ◽  
Roberto Sávio Bessa da Silva ◽  
Araceli Alves Dutra ◽  
Brizza Zorayd Luz Lopes Rocha ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Urinary Tract ◽  
Renal Pelvis ◽  
Blood Count ◽  
Complete Blood Count ◽  
Excretory Urography ◽  
Definitive Treatment ◽  
Ectopic Ureter ◽  
Wide Range ◽  
Contrast Radiography

Background: Ureteral ectopia (or ectopic ureter) is a congenital anomaly of the urinary system in which the ureter inserts anywhere other than the vesical trigone. This anatomical change may have unilateral or bilateral involvement. The most evident clinical sign, occurring mostly in females, is urinary incontinence, however in some cases the condition may progress to nephritis and dilation of the renal pelvis. The diagnosis is established through imaging, and definitive treatment requires surgical approach. The present study reports a case of ureteral ectopia in a dog which was diagnosed by ultrasound and contrast radiography (excretory urography) and successfully treated by neoureterostomy.Case: A 10-month-old female American Pit Bull Terrier was attended at the Veterinary Hospital of the Federal Rural University of the Semi-Arid (UFERSA), in Mossoró, RN. Her owner reported incontinence of dark, malodorous urine since birth as the chief complaint. After clinical examination, cystitis was suspected, and a complete blood count, urinalysis, and abdominal ultrasound was requested. The blood count and creatinine were within the reference values. The presence of struvite crystals were found on urinalysis. Ultrasound examination revealed a tortuous, dilated right ureter from the renal pelvis to the urinary bladder; no uroliths were identified as a cause of potential obstruction, but the ipsilateral kidney showed increased cortical echogenicity, loss of corticomedullary definition, and moderate pelvic dilation. These findings supported a presumptive diagnosis of ectopic ureter. For the purpose of confirming this suspicion, excretory urography was performed, revealing unilateral ureteral dilation and radiopaque contrast uptake following the path of the urethra. Once the diagnosis was confirmed, surgery was performed to correct the ureteral ectopia using the standard neoureterocistostomy technique. Considering the unilateral involvement, location of the insertion, and preserved renal function, the decision was made to perform a neoureterostomy. During the surgery it was possible to identify that the ectopic ureter was found to be intramural. At 2-month follow-up, urinary incontinence had resolved and control ultrasound showed significant improvement in the inflammatory appearance of the right renal parenchyma, with no signs of dilation of the renal pelvis or ureter.Discussion: Different from what happens in male dogs, females with an ectopic ureter will often present with urinary incontinence as the main (and, often, only) symptom, usually in the first months of life. As pollakiuria suggests a wide range of diseases of the urinary tract, ultrasound was considered the first-line imaging modality of choice, indispensable for ruling out other differential diagnoses such as a severe urinary tract infection, urolithiasis, or even malignancy. Despite the literature reporting that urinary incontinence persists in 44 to 67% of cases of ureteral ectopia, even after surgery in this case there was complete recovery of the patient after two months. Accessible techniques like ultrasonography and contrast radiography (excretory urography) supplemented one another in the elucidation of this case, with both demonstrating an excellent contribution to the diagnosis of ectopic ureter as well as served as support for surgical planning, enabling effective repair and consequent recovery of the patient. 

Urinary Incontinence in a Dog With an Ectopic Ureterocele

2002 ◽  
Vol 38 (1) ◽  
pp. 29-32 ◽  
Author(s):  
Sarah J. Lautzenhiser ◽  
Dale E. Bjorling
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Incontinence ◽  
Urinary Tract ◽  
Urethral Diverticulum ◽  
Excretory Urography ◽  
Ectopic Ureter ◽  
Ectopic Ureterocele ◽  
Distal Ureter ◽  
Tract Infections

A 7-month-old, female English cocker spaniel was examined because of a complaint of urinary incontinence. Excretory urography revealed a small right kidney and right-sided hydroureter, ectopic ureter, and ureterocele. Ureteronephrectomy and ovariohysterectomy were performed, but the distal ureter and ureterocele were left in situ. Recurrent urinary tract infections and intermittent urinary incontinence persisted after surgery. Vaginourethrography demonstrated the presence of a urethral diverticulum associated with the ureterocele. Ureterocelectomy was performed, and the dog remains continent 4 years after ureterocelectomy. Persistent urinary incontinence and urinary tract infection were attributed to failure to resect the ureterocele.

Neoureterocystostomy for the management of extramural ectopic ureter with concurrent contralateral renal aplasia in two dogs

2019 ◽  
Vol 7 (2) ◽  
pp. e000766 ◽  
Author(s):  
Luca Bresciani ◽  
Josep Aisa ◽  
Jonathan Bray ◽  
Audrey Petite ◽  
Susanna Spence
Keyword(s):  
Urinary Incontinence ◽  
Blood Count ◽  
Complete Blood Count ◽  
Clinical Signs ◽  
Abdominal Distension ◽  
Abdominal Imaging ◽  
The Other ◽  
Ectopic Ureter ◽  
Renal Aplasia ◽  
Routine Investigations

Two male puppies were presented: one with urinary incontinence and the other with abdominal distension and discomfort. A diagnosis of unilateral extramural ectopic ureter with associated hydronephrosis/hydroureter and contralateral renal aplasia was confirmed in both patients by a combination of abdominal imaging and exploratory coeliotomy. Both patients were also diagnosed with cryptorchidism ipsilateral to the renal aplasia. Routine investigations, including complete blood count, biochemistry and urinalysis, were otherwise unremarkable. Neoureterocystostomy with an intravesical technique and castration were performed in both patients. One month following surgery, severity of clinical signs, the degree of hydronephrosis/hydroureter and elevation of renal blood values had all improved in both patients.

Double Ureters With Ureteral Ectopia in a Domestic Shorthair Cat

2006 ◽  
Vol 42 (6) ◽  
pp. 462-466 ◽  
Author(s):  
Seth N. Ghantous ◽  
Jason Crawford
Keyword(s):  
Congenital Anomaly ◽  
Urinary Tract Infection ◽  
Urinary Incontinence ◽  
Urinary Tract ◽  
Complete Resolution ◽  
Urine Culture ◽  
Excretory Urography ◽  
Ureteral Duplication ◽  
Double Ureters ◽  
Ectopic Ureters

A 5-month-old domestic shorthair cat was presented for evaluation of urinary incontinence since birth. Excretory urography revealed dilated double ectopic ureters draining a hydronephrotic right kidney. Urine culture yielded a pure culture of Klebsiella pneumoniae. The cat was treated initially with bactericidal antibiotics, followed by right-sided nephroureterectomy. The surgery and antibiotic therapy led to complete resolution of urinary incontinence and urinary tract infection. Ureteral duplication is an unusual congenital anomaly that has not been previously reported in the cat.

scholarly journals Use of Monopolar Cauterization for Ectopic Intramural Ureter Correction by Cystoscopy in Bitch

2019 ◽  
Vol 47 ◽  
Author(s):  
Ariele Aparecida Ferreira ◽  
Neíse Nathalie Guariza Tortato ◽  
William Timboni Teixeira ◽  
Vinicius Gonzales Peres Albernaz ◽  
Roberto Carareto ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Urinary Tract ◽  
Surgical Repair ◽  
Case Reports ◽  
Urinary Continence ◽  
Invasive Technique ◽  
Limiting Factor ◽  
Ectopic Ureter ◽  
Lower Urinary Tract Infection ◽  
English Bulldog

Background: The ectopic ureter (EU) is considered a congenital anomaly in which the ureteral aperture opens in a position other than the bladder neck. The diagnosis involves the use of different methods or combination of image exams, including excretory urography, pneumocystography, ultrasonography, cystoscopy and computed tomography. The technics for surgical repair should be considered evaluating the number and functionality of the EU, the location of the ureteral opening, functional condition of ipsilateral kidney and the presence of other abnormalities. The case reports aims to show the surgical repair of an intramural EU in an English Bulldog bitch by cystoscopy-guides monopolar cautery.Case: A 1-year-old English Bulldog bitch received medical care due to a history of urinary incontinence since a few months of life. The animal had laboratory abnormalities compatible with lower urinary tract infection, followed by a profound growth of Klebsiella sp in urine culture, and received antibiotic treatment for 21 days based on antibiogram results. Due to a suspect EU, a urinary tract tomography was performed and indicated a congenital kidney malformation (renal dysplasia), enlargement and distal insertion of the left ureter (in comparison with the contralateral one), rising suspiciously of its intramural progression. We choose to proceed to cystoscopy examination, in which both right and left ureteral ostium could be seen in the urethral region. A guide of a pigtail catheter was inserted through both ureteral ostia in order to orient the ureteral incision. The monopolar cautery was inserted in cystoscopy working channel to section the mucosa of EU channel on urethra region, separating the lumen of EU from the urethra and extending the incision cranially inside the urinary bladder lumen. After a complete section of the ectopic tissue, a pigtail urinary catheter was correctly placed in both ureters. After bilateral repair of EU, the bitch showed a significative decrease of urinary incontinence, although completer resolution could not be obtained.Discussion:Studies showing the treatment of EU using the ablation of the tissue separating the ureteral and urethral or bladder lumen using cystoscopy-guided laser showed lower post-operative pain and hospitalization time, besides being a minimally invasive technique in comparison with traditional surgery. The limiting factor is the specialized equipment required for the procedure. In our surgical routine, there is a cystoscope, however, we do not own a diode laser or radiofrequency equipment. The adaptation of a monopolar cautery with the objective of correct an intramural EU proved to be feasible in practice since we achieved satisfactory recovery of the patient, similar than what is seen with lasers. Even after surgical repair of both EU, the patient sustained urinary incontinence, although lesser than before surgery. The remaining of the clinical sign, in this case, is compatible with the low rate of postoperative urinary continence in bitches, irrespective of the surgical technique, varying between 25% and 58% with or without medical treatment. To our knowledge, there was no published report on the use of monopolar cautery to treat EU. The monopolar cautery can be used as a less invasive and alternative technique to traditional surgery in the treatment of intramural EU through cystoscopy in bitches.

scholarly journals Ureteral Stent Placement Using a Double J-Catheter in the Treatment of Ectopic Ureter in a Dog

2020 ◽  
Vol 48 ◽  
Author(s):  
Guilherme Sembenelli ◽  
Jose Sergio Costa Junior ◽  
Monica Carolina Nery Wittmaack ◽  
Gabriel Luiz Montanhim ◽  
Luis Gustavo Gosuen Gonçalves Dias ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Urinary Tract ◽  
Surgical Treatment ◽  
Renal Pelvis ◽  
Stent Placement ◽  
Ureteral Stent ◽  
Urethral Obstruction ◽  
Ectopic Ureter ◽  
The Right ◽  
Tract Infections

Background: Ectopic ureter is a congenital anomaly in which the final segment of one or both ureteral orifices is located distal to the bladder trigone. It may be classified as intra- or extramural. Surgical treatment of ectopic ureters in dogs is recommended and the approach varies with the classification. In the postoperative period, complications are common. When stenosis of the new ureteral ostium occurs, immediate repeated surgery is recommended. This study aimed at using the double J catheter placement following neoureterostomy to treat urethral obstruction secondary to the surgical treatment of an intramural ectopic ureter in a dog.Case: An 8-month-old female French bulldog with dysuria and urinary incontinence was seen at a private veterinary hospital in Jaboticabal, São Paulo. The patient had previously been diagnosed with an intramural ectopic ureter on the right side following imaging tests (ultrasound, computed tomography, and abdominal radiography, excretory urography) and had undergone neoureterostomy and closure of the intramural pathway approximately a year ago. Ultrasonographic examination showed dilation of the caudal portion of the ureter and hydroureter, which was suggestive of right ureteral stenosis. Computed tomography was also performed to evaluate the kidneys, ureters, and bladder; an increase in the diameter of the right ureter in its middle portion and close to the bladder triangle was observed. A new surgical intervention was indicated and performed. The ureteral route was identified in a region of the bladder trigone, incised, and probed with a urethral probe No. 04. The intramural course in the proximal urethra was identified and probed with a 16G epidural catheter. It was necessary to perform a neoureterostomy. A longitudinal incision (spatulation) of approximately 5 mm was made in the distal portion of the right ureter to increase the circumference of the anastomosis. The double J 4.7 French (Fr) catheter was inserted through the new ureter ostium into the bladder and advanced into the right kidney in a retrograde manner. Once the proximal end of the double J catheter reached the renal pelvis, the guidewire was withdrawn slowly to allow the catheter to bend in the areas of the renal pelvis and the trigone. The distal end of the double J catheter that extended beyond the bladder lumen was sectioned for better bladder closure. The patient underwent clinical evaluation and laboratory tests (complete blood count and serum creatinine concentration, urine test with bacteriological culture and susceptibility test) 2 weeks after the procedure and, subsequently, every 3 months. Ultrasonography of the urinary tract was performed every 2 months.Discussion: We used a double J catheter in the patient due to a previous obstruction of the ureter ostium after the first surgical procedure. In this way, complications such as postoperative obstructions due to ureteritis and ureteral constriction were avoided and ureteral anastomosis was facilitated. It has been reported that animals subjected to ureteral stent placement have high incidences of dysuria and urinary tract infection, and low incidences of stent migration and occlusion. In this case, no signs of occlusion or obstruction of the implant were identified, but there was a recurrence of urinary tract infections. These frequently cause urethral obstruction associated with the healing of the new ureteral ostium. Patient follow-up and findings associated with the long-term insertion of the double J catheter provide support for the clinical relevance of the present report.

Paediatric urology

2019 ◽  
pp. 669-730
Author(s):  
John Reynard ◽  
Simon F Brewster ◽  
Suzanne Biers ◽  
Naomi Laura Neal
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Incontinence ◽  
Urinary Tract ◽  
Nocturnal Enuresis ◽  
Vesicoureteric Reflux ◽  
Ectopic Ureter ◽  
Fourth Edition ◽  
Paediatric Urology ◽  
Management Recommendations ◽  
Guidelines And Recommendations

This chapter covers paediatric urology, and the fourth edition includes the latest guidelines and recommendations (National Institute for Health and Care Excellence 2013, British Association of Paediatric Urologists 2015). The embryology of the urinary and genital tracts is detailed. The presentation of undescended testes, vesicoureteric reflux, and urinary tract infection and their current management recommendations are included. New sections in the fourth edition include paediatric trauma, nephrolithiasis, uro-physiology, and the foreskin. Megaureter, ectopic ureter, and ureterocele are also covered in detail. Hypospadias and epispadias are covered. This chapter also includes the assessment and management of children with urinary incontinence and nocturnal enuresis.

Diagnostic Values of Complete Blood Count in Patients with Urinary Tract Infection

2019 ◽  
Vol 10 (10) ◽  
pp. 2368
Author(s):  
Thekra Ahmed Hamada AL-Tikrity ◽  
Marwa Tariq Ahmed Al-Douri ◽  
Mohammed Mohsin Abdul-Aziz ◽  
Usama Mohmmad Abbas Al-Jebouri
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Blood Count ◽  
Complete Blood Count ◽  
Diagnostic Values

Ectopic Ureterocele in a Cat

2005 ◽  
Vol 41 (5) ◽  
pp. 332-335 ◽  
Author(s):  
Jason G. Eisele ◽  
Joshua Jackson ◽  
Dave Hager
Keyword(s):  
Urinary Incontinence ◽  
Excretory Urography ◽  
Surgical Correction ◽  
Ectopic Ureter ◽  
Ectopic Ureterocele ◽  
The Right

A 9-month-old, castrated male domestic shorthair cat with urinary incontinence was referred for surgical correction of an ectopic ureter. Excretory urography revealed hydronephrosis of the right kidney, right hydroureter, and ureterocele. A partial ureterocelectomy and neoureterocystostomy were performed. This report describes the surgical modification of the ureterocele and ectopic ureter to correct ipsilateral hydronephrosis, hydroureter, and urinary incontinence.

scholarly journals Extravesical reimplantation of an extravesical-ectopic ureter from the upper pole of a duplicated kidney

2021 ◽  
Vol 9 (4) ◽  
pp. 133-141
Author(s):  
G. A. Makarov ◽  
V. V. Sizonov ◽  
V. M. Orlov ◽  
V. V. Vigera
Keyword(s):  
Urinary Tract Infection ◽  
Uric Acid ◽  
Urinary Incontinence ◽  
Urinary Tract ◽  
Endoscopic Treatment ◽  
Recurrent Urinary Tract Infection ◽  
Morphological Changes ◽  
Upper Urinary Tract ◽  
Ectopic Ureter ◽  
Histopathological Changes

Extravesical ureter ectopia is a rare cause of urinary incontinence. We are reporting a case of a 3-year-old girl with urinary incontinence. The girl was observed and treated for recurrent urinary tract infection (UTI) against the background of left-side duplication of the upper urinary tract and vesicoureteral reflux (VUR). Two-time endoscopic treatment using a dextranomer/hyaluronic acid allowed to eliminate VUR on both sides and achieve stable clinical and laboratory remission of UTI. After potty training, the child had a constant drip of urine along with normal urination. The examination revealed extravesical ureter ectopia of the left duplicated kidney upper pole and a bladder space-occupying mass with hyperdensive inclusions in the projection of the vesical trigone on the left, which we regarded as a result of the migration of the implant and the appearance of histopathological changes in it. The presence of a bladder space-occupying mass determined the choice of the surgical technique in favor of the formation of a ureterocystoanastomosis with a duplicated ectopic ureter and the removal of a bladder space-occupying mass. When managing patients after endoscopic treatment of VUR, it should be considered the possibility of morphological changes in the bulking agent due to the accumulation of calcium and uric acid salts.

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