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Single ureteral ectopia with congenital renal dysplasia.

PURPOSE
We reviewed the clinicopathological features and surgical management of 16 cases of single ureteral ectopia with congenital renal dysplasia.


MATERIALS AND METHODS
Excretory urography, retrograde ureterography, computerized tomography, diuretic B-mode ultrasound (B-US) and color Doppler imaging (CDI) were performed in 16 females. Explorative operations were performed in all 16 patients and renal dysplasia was further confirmed by pathological examination.


RESULTS
The 16 female patients were 1.5 to 12 years old. The main clinical signs were urinary incontinence accompanied by regular voiding since birth. Vaginal ectopic ureters were observed in 6 patients and vestibular ureters in 10. Excretory urography did not show dysplastic kidney except some indirect signs of renal dysplasia. Computerized tomography clearly revealed renal dysplasia in 4 of 9 cases performed without contrast medium. Dysplastic kidneys were precisely located and diagnosed by diuretic B-US in 6 of 8 cases, and by CDI in 7 of 7 cases. Nephrectomy was performed in all 16 patients with satisfactory results.


CONCLUSIONS
Single ureteral ectopia with congenital renal dysplasia is exceedingly rare. B-US, especially CDI, is the recommended procedure for preoperative localization and diagnosis. Nephrectomy of dysplastic kidney is the treatment of choice.