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Vaginal Tract Anomalies
Published in S Paige Hertweck, Maggie L Dwiggins, Clinical Protocols in Pediatric and Adolescent Gynecology, 2022
Imaging: pelvic and renal ultrasoundWhen a solitary kidney is present, ectopic ureter should be ruled out, as it will be present in about 9% of cases and often drains into the obstructed hemivagina
Ureteric duplication
Published in Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg, Operative Pediatric Surgery, 2020
Sarah L. Hecht, Duncan T. Wilcox
Isolated VUR in duplex systems is treated as it is in single systems. When VUR is present in addition to an ectopic or obstructed ureter requiring intervention, ureteral reimplantation is the procedure of choice. Distally, duplicated ureters are often located within a common sheath and share a distal blood supply. In this case, ureters must be mobilized and reimplanted en bloc. An ectopic ureter will not necessarily share a blood supply with the lower-pole ureter. In this case, the ureters can be reimplanted independently, although this is technically very difficult and it is often better to excise the distal part of the ectopic ureter and perform an en bloc ureteric reimplant of both ureters. Alternatively, a combination upper-to-lower ureteroureterostomy and lower ureteral reimplant may be performed.
Pediatric urology
Published in Joseph S. Sanfilippo, Eduardo Lara-Torre, Veronica Gomez-Lobo, Sanfilippo's Textbook of Pediatric and Adolescent GynecologySecond Edition, 2019
Laurel Sofer, Emilie K. Johnson
An ectopic ureter is one that opens into the bladder in an aberrant location. It may be associated with the upper pole of a duplicated collecting system or a single ectopic ureter. The most common orifice locations are the bladder neck, the proximal or distal urethra, and the vaginal vestibule, but may enter anywhere from the bladder neck to the perineum, including the vagina, cervix, or uterus. If the orifice is beyond the external urinary sphincter, it may cause continuous urinary incontinence in females.43
64 MS-CTU: Review of techniques and spectrum of the ureteric diseases
Published in Alexandria Journal of Medicine, 2018
This ectopic distal ureteric termination may be also seen in non-duplicated ureters; as seen in one patient of this study (0.25%) (Fig. 3). The ectopic ureter in females usually presents with urinary incontinence due to the usual insertion of the ectopic feminine ureter below the external urethral sphincter. In contrast to males, whose ectopic ureter may insert on the posterior urethra, seminal vesicle, vas deferens, bladder neck, or prostate, hence it commonly has obstructed distal end. Males with ectopic ureter do not present with incontinence because unlike females, their ectopic ureter has a distal end superior to the level of the external urethral sphincter. Males with an ectopic ureter commonly present with a urinary tract infection. One of the beneficial applications of CTU is its higher sensitivity for accurate diagnosis of this duplication anomaly. It is much more sensitive than the conventional IVU, as it can clearly show it even in cases with non-functioning anomalous side kidney, which is not uncommon in the complete duplication type with ectopic ureteric orifices or severe VUR.15
Ultrasound versus fluoroscopy-guided ureteroscopy for distal ureteric stones in adults
Published in Arab Journal of Urology, 2022
Ahmed Reda, Yaser Mahmoud Abdelsalam, Mohamed Loay Shehata, Salah El-Din Shaker, Mohammad Abbas Faragallah
After institutional review board approval, this study was conducted from April 2018 to April 2020. It was a single-center, open-label, randomized, non inferiority, parallel-treatment clinical trial. Included patients were 18 years old or more presented by a single symptomatic distal third ureteric radio-opaque stone with the longest dimension of ≤15 mm. We excluded all patients with bilateral ureteric stones, those with solitary functioning kidney, ureteric congenital anomalies (e.g. double ureter or ectopic ureter), previously failed URS, prior ureteric stenting, previous ureteric surgery such as ureteroneocystostomy, uremic patients and pregnant women. Counseling for participation was provided before recruitment, and written consent was obtained from eligible participants.