What is an ectopic ureter?

Ectopic ureter is a congenital disease that greatly affects the psychology and quality of life of patients. The disease is often detected late because the symptoms are not specific, easily confused with the normal state of the child.

Normally, the ureter empties into the back of the bladder. The two openings of the ureter together with the bladder neck form a triangle, known as the bladder triangle. The condition in which the ureters that connect the orifices stray from the upper triangle are called ectopic ureters. In other words, an ectopic ureter is a condition where the ureteral opening empties outside the triangle of the bladder.
Ectopic ureter is a rare congenital disease. On average, 1 out of every 2000 children will have the disease. The incidence of the disease is higher in girls than in boys and mainly comes from the upper pole of the double kidney.
In boys: ectopic ureters into the urethra, seminal vesicles, vas deferens, prostate gland; In female children: The ureter is displaced into the lower bladder neck, vestibular area, vagina, vulva, and uterus. Abnormal development of the ureter during fetal life leads to ectopic ureteral disease. Abnormal location of the ureteral germ on the mesonephrosis or late separation of the ureteral germ from the mesonephric is a risk factor for ectopic ureter.
Based on location, ectopic ureters can be divided into two types, including:
Ectopic ureters in the bladder: Two ureters still open into the bladder, but one or both ureters open to the outside bladder triangle region; Ectopic ureter outside the bladder: One of the two ureters or one of three to four accessory ureters open to the outside of the bladder.

Patients with ectopic ureter will have the following symptoms:
Diarrhea: This is the basic symptom of ectopic ureter. Children with ectopic ureters will have a constant leak of urine. This is a congenital disease, so when the child is young, parents may confuse it with bedwetting, and the young child goes to the toilet continuously, so it is difficult to distinguish. It is not until the child is older and more knowledgeable that abnormal symptoms are discovered. This is why ectopic ureteral disease is often detected late; The amount of urine leaking from the ectopic ureter is not much, about 20-70ml on average. Children often have to change their pants twice a day, adults have to change their pants 3-4 times a day. This is a sign that distinguishes an ectopic ureter from a vesico-vaginal fistula; Peeing on the wall: Besides the continuous leakage of urine, the patient can still urinate normally; Symptoms of infection. Physical examination:
Examining the vaginal area, outside the vagina, the genitals will see the opening of the urethra plugged into the vagina, vestibular area...; Color test; Check for secondary symptoms: Sores in the groin and thighs due to continuous leaking of urine causing prolonged wetness.

Based on the patient's clinical symptoms
Cystoscopy, using color test; Urethroscopy, using color test; Venous urogram; Upstream image from the ectopic ureteral orifice (in case the orifice is found during examination).

Sores, inflammation of the skin of the thighs, groin, genitals due to continuous leakage of urine, causing prolonged wetness; The infection is upstream and leads to accessory kidney failure. An ectopic ureter can lead to dangerous complications, severely affecting kidney function. Therefore, patients with ectopic ureters should be taken to the doctor as soon as possible for timely intervention.