Renal dysplasia with single system ectopic ureter: Diagnosis using magnetic resonance urography and management with laparoscopic nephroureterectomy in pediatric age

Abstract

Single system ureteral ectopia and associated congenital dysplastic kidney is surgically curable etiology of incontinence with other wise normal pattern of voiding in female child. We share our experience of eight cases in last one year and its management with laparoscopic nephroureterectomy at a tertiary care hospital in India which is one of the largest series in such a short duration of this rare anomaly.Materials and Methods:Patients presented with clinical features of continence with otherwise normal pattern of voiding were clinically examined and investigated by ultrasound (USG), nuclear renal scan, magnetic resonance urography (MRU). Laparoscopic nephroureterectomy was done in all the eight cases and renal dysplasia was confirmed on histological examination.Results:All the patients were females in the age group of five months to five years. USG detected the renal dysplasia in three out of eight cases; however, it could not detect the course of the ectopic ureter in any of the cases. MRU picked up the dysplastic moieties and their location as well as functional status and also depicted the course of the ectopic ureter opening into the vaginal wall in all the eight cases. Laparoscopic nephroureterectomy was done in all the cases and patients were cured off their symptoms.Conclusion:Single system ectopic ureter associated with congenital renal dysplasia is exceedingly rare. MRU is definitely the better investigation for the diagnosis of this condition as compared to the conventional radiological investigations. Laparoscopic nephroureterectomy is a very good procedure for the management of these cases.