Intramural Ectopic Ureters Research Articles

Bilateral Ureteral Ectopia With Renal Dysplasia and Urolithiasis in a Dog

A 7-month-old, 4.3-kg, spayed female bichon frise was referred for evaluation of chronic urinary incontinence. Abdominal radiographs revealed calculi within the right kidney and ureter. An ultrasound revealed a small right kidney. An abdominal computed tomography scan with contrast revealed that the left ureter was extramurally ectopic, inserting into the proximal urethra. A right intramural ectopic ureter was identified during cystotomy. Ureteronephrectomy was performed on the right, and ureteroneocystostomy was performed on the left. A telephone conversation with the owner 4 months after surgery revealed that the dog exhibited no evidence of urine dribbling, and urinary continence was maintained well on phenyl-propanolamine (1.75 mg/kg orally q 12 hours). This is the first report of successful surgical management of bilateral ureteral ectopia with concurrent, unilateral, renal dysplasia and urolithiasis.

Use of cystoscopic-guided laser ablation for treatment of intramural ureteral ectopia in male dogs: four cases (2006–2007)

To describe and evaluate the outcome of cystoscopic-guided laser ablation of intramural ureteral ectopia in male dogs. Retrospective case series. 4 incontinent male dogs with intramural ureteral ectopia. Intramural ectopic ureters were diagnosed via preoperative computed tomography-IV urography and subsequent cystoscopy. Transurethral cystoscopic-guided laser ablation (diode laser [n = 3 dogs] and holmium:yttrium aluminum garnet laser [1]) was performed to proximally relocate the ectopic ureteral orifice to the urinary bladder. Fluoroscopy was used during the procedures to confirm that the ureteral tract was intramural and the ureteral orifice was intravesicular after the procedure. In 1 dog with bilateral ureteral ectopia, staged laser ablation was performed at 6-week intervals because of difficulty viewing the second ureter on the first attempt. All ureteral orifices were initially located in the middle to proximal portion of the prostatic portion of the urethra. Six weeks after surgery, imaging was repeated in 3 of 4 dogs. Postoperative dysuria or hematuria did not develop. All dogs were immediately continent after laser treatment and remained so at a median follow-up period of 18 months (range, 15 to 20 months) without medical management. Ureteral ectopia can cause urinary incontinence in male dogs and is usually associated with other urinary tract abnormalities. Cystoscopic-guided laser ablation provided an effective and minimally invasive alternative to surgical management of intramural ureteral ectopia.

Comparison of two surgical techniques for management of intramural ureteral ectopia in dogs: 36 cases (1994–2004)

To determine outcome associated with intramural ureteral ectopia treated with 1 of 2 surgical techniques (neoureterostomy with ligation of the distal ureteral segment vs neoureterostomy with resection of the distal ureteral segment) and compare results of these 2 techniques in dogs. Multicenter retrospective case series. 36 dogs (15 treated with the ligation technique and 21 treated with the resection technique). Information was obtained from medical records. Long-term follow-up information was obtained by owner questionnaire. 15 of 21 (71%) dogs in the resection group and 7 of 14 (50%) dogs in the ligation group still had urinary incontinence after surgery. Three of 20 (15%) dogs in the resection group and 4 of 14 (29%) dogs in the ligation group reportedly had multiple episodes of urinary tract infection following surgery. The outcome of surgery was judged to be excellent by the owners of 10 of 18 (56%) dogs in the resection group and 9 of 14 (64%) dogs in the ligation group. No significant differences were found between surgery treatment groups. Results of the present study suggest that although most owners of dogs that undergo surgery for treatment of intramural ureteral ectopia consider the outcome of surgery to be excellent, substantial proportions of dogs will continue to have urinary incontinence and recurrent urinary tract infections after surgery. Findings do not provide any support to the hypothesis that the resection technique is superior to the ligation technique for management of dogs with intramural ureteral ectopia.