Ectopic ureter in a patient with a non-duplex hypoplastic kidney

Abstract

Ectopic ureter (EU) is a rare urinary tract malformation often found in patients with a duplex kidney. Abnormal location of the ureteral orifice in a non-duplex kidney is observed in 20–25% cases of all ectopias. The paraurethral EU is described in very few publications. An 8-year-old female patient complained of periodic abdominal pain, inflammatory changes in the urinary sediment, and periodic urinary incontinence. The child had not been examined earlier. Ultrasonography findings: left kidney size 41 × 20mm; the ureter was dilated along its entire length and has bends; the diameters of its upper and thirds were 16 mm and up to 23 mm, respectively. Cystography showed no evidence of vesicoureteral reflux. Contrast-enhanced computed tomography findings: the orifice of the left ureter was not visualized; there was a significant decrease in the function of the left kidney and dilation of the left ureter. Findings of cystoscopy under anesthesia: the orifice of the left ureter was in the bladder; the bladder neck was not visualized. During the examination of the area between the urethra and the vagina, we found the orifice of the left ureter located to the left of the midline. The patient underwent laparoscopic left-sided nephroureterectomy. Six months postoperatively, the patient had no urinary incontinence and no urinary syndrome. Static renal scintigraphy showed that the index of integral uptake on the right was 108; the total volume of the functioning parenchyma was not reduced. Key words: ectopic ureter, nephroureterectomy, children.