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Ectopic Ureter

Ectopic Ureter
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Ectopic Ureter Illustration
Ureters are the two funnel-shaped tubes that carry urine from the kidneys to the bladder. A ureter that does not connect properly to the bladder and drains somewhere outside of the bladder is called an ectopic ureter. In boys the ectopic ureter usually drains into the urethra closer to the prostate. In girls the ectopic ureter usually drains into the reproductive organs or urethra. Ectopic ureters are most commonly associated with a duplex kidney, where one kidney has two separate ureters; one of the ureters drains normally into the bladder, but the second is ectopic.

What symptoms are associated with an
ectopic ureter?

What studies might my child undergo?

How is an ectopic ureter treated?

Surgical options

Cutaneous distal ureterostomy: This may be necessary in a newborn with massive ureteral dilation. The ureter is surgically brought to the surface of the skin to allow it to drain urine freely into the diaper. This allows the affected kidney and ureter to decompress. Around 18 months of age, the ureter is then reimplanted into the correct position in the bladder.

Ureteral reimplantation: Under general anesthesia and through a lower abdominal incision, the ureter is reimplanted into the correct position where it joins the bladder. At CHOP this procedure can be done through a minimally invasive surgery (MIS) using a laparoscopic or robotic approach. The minimally invasive approach is accomplished through three small incisions, the size of a grain of rice. The advantages are smaller, less visible incisions and overall, a quicker recovery period. The minimally invasive technique is not appropriate for all children. Each year, approximately 50 ureteral reimplantations are done at CHOP. Your provider will work with you and your family to determine what kind of intervention is best.

Partial nephrectomy: If the ectopic ureter is associated with a duplex kidney and the upper pole of the kidney does not function well, it might be recommended to remove that portion of the kidney. At CHOP a partial nephrectomy can be done through a minimally invasive surgery (MIS).

Ureteropyelostomy: If the ectopic ureter is associated with a duplex kidney, the upper pole of the duplex kidney can be divided and connected to the normal lower part of the kidney. This allows the urine from the upper part of the kidney to drain normally. This procedure can also be done through a minimally invasive surgery (MIS).

Reviewed by: Jennifer Kirk, BSN, MSN, CPNP
Date: Oct. 2011

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