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Single system ureteral ectopia in boys associated with bladder outlet obstruction
R Mathews1, R D Jeffs, M Maizels
1Division of Pediatric Urology, James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
The Journal of Urology
|March 19, 1999
Summary
Single system ureteral ectopia in boys can mimic posterior urethral valves, causing bladder outlet obstruction. Surgical intervention, including reconstruction, is crucial for managing this rare anomaly.
Area of Science:
- Pediatric Urology
- Congenital Anomalies
- Urological Surgery
Background:
- Ureteral ectopia with renal dysplasia is common in girls with ureteral duplication.
- Single system ureteral ectopia is a rare anomaly, more prevalent in boys.
- This condition can lead to significant clinical challenges.
Observation:
- This study reports on 6 boys with single system ureteral ectopia into the prostatic urethra.
- Patients presented with radiological and clinical signs of bladder outlet obstruction.
- Antenatal ultrasounds identified abnormalities, and postnatal studies suggested obstruction.
Findings:
- Ectopic ureters were found inserting into the prostatic urethra in all 6 boys.
- Dilated distal ureters elevated the bladder neck, causing obstruction.
- Surgical management involved nephrectomy or nephroureterectomy with urethral reconstruction.
- Two younger boys developed voiding dysfunction post-surgery.
Implications:
- Single system ectopic ureters in boys can present atypically, resembling posterior urethral valves.
- Surgical treatment should address the ectopic ureter and reconstruct the prostate.
- Long-term voiding dysfunction is a potential complication requiring monitoring.