Diagnosis and surgical management of ectopic ureters

Ureteral ectopia is a congenital abnormality of the terminal segment of one or both ureters in which the ureteral orifice is located distal to the trigone of the bladder. Continuous or intermittent urinary incontinence is the most frequently reported clinical symptom associated with ureteral ectopia. A variety of anatomic morphologies of ectopic ureters have been reported. Historically, surgical therapy focused on reestablishing drainage of the ureters into the bladder lumen. However, continued urinary incontinence after surgery is the most frequently reported complication. Specific classification and successful management of the various types of ectopic ureters remain diagnostic and therapeutic challenges to the veterinary clinician. Cystoscopic evaluation of the lower urinary tract and urodynamic evaluation of bladder and urethral function has improved the presurgical assessment of the patient. Surgical procedures, which are aimed at repositioning the ureteral orifice(s) within the bladder lumen and treating primary sphincter incompetence, are necessary to successfully manage small animal patients with ectopic ureters.