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

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.

Congenital ureterovaginal fistula: a rare case of single-system ectopic ureter with ipsilateral ectopic kidney managed by vaginal approach: a case report

Background Diagnosing urinary incontinence from organic causes such as ectopic ureter is particularly important because of the potential for cure by surgical correction. The prevalence of ectopic ureter is uncertain because many are asymptomatic and the diagnosis is usually overlooked. Eighty percent of ectopic ureters in females are often associated with duplex kidney. However, an ectopic ureter draining a single-system ectopic dysplastic/atrophic but functioning kidney is rare, especially in females. The overall long-term continence rate after successful correction of ectopic ureter is satisfactory. Case presentation This case is reported to highlight a rare situation, where a 22-year-old nulligravid Ethiopian women presented with a complaint of continuous wetting of her underwear since childhood, but she had normal voiding pattern. Localized right pelvic kidney ultrasound and computed tomography scan with contrast revealed right ectopic ureter and atrophied ipsilateral pelvic kidney with good function. Surgical reimplantation through vaginal approach was performed, and the outcome was good. The patient’s subsequent follow-ups were uneventful. Conclusion An extramural vaginal ectopic ureter is better accessed through transvaginal approach than abdominal, especially when it is associated with pelvic ectopic kidney. This modified approach is less invasive and has lower morbidity and better success rate than a transabdominal approach.

Surgical correction of bilateral ectopic ureter using the neoureterocystostomy technique

Ureteral ectopy is a rare disorder in the small animals’ clinic. It is characterized as a congenital anomaly, resulting from the ducts differentiation failure during embryogenesis. In this scenario, the ureters present themselves outside the anatomical site, being inserted into the uterus, urethra, urinary vesicle neck, or vagina. The clinical signs are urinary incontinence and perivulvar dermatitis. Surgery is the accepted treatment to correct the anomaly. The surgical procedure is based on relocating the ectopic ureter and treating associated modifications. This report describes a case of intramural bilateral ureteral ectopy, corrected surgically through the neoureterocystostomy technique, making it possible to control the animal’s urinary incontinence.