[Combinations of different types and variants of ectopia of the ureteral ostia]

Ectopias of the ostia ureteris are generally accepted to be divided into intra- and extravesical ones. It is expedient to divide this abnormality into lower (that of the ureteral ostium below and more medial than the normal site) and upper (that of above and more lateral than the normal site) ectopias of the ostia ureteris. The lower ectopia may be intra- and extravesical. The upper ectopia may be also intra- and extravesical. In ureteral ostial ectopia, the passage of urine from the kidney into the urinary bladder is impaired due to either mechanical ureteral obstruction or vesicoureteral reflux. The lower intravesical ectopia of the ostium ureteris is frequently associated with ureterocele. The study was undertaken to examine 242 patients with ectopia of the ostia ureteris, including those with extravesical (5.3%), intravesical (93.8%) and associated (0.9%) ectopias. Lower ectopia of the ostia ureteris was observed in 28.5%, upper, in 64.5%, and associated ones in 7%. The authors outline 14 different combinations of various types and variants of ureteral ostial ectopias which were observed in 25 patients. The diagnosis of such complicated abnormalities may be made only on the basis of knowledge of all the variants of lower and upper ectopias of the ostia ureteris. All these abnormalities require surgical correction.