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Related Experiment Videos

Bilateral single ureteral ectopia: difficulty attaining continence using standard bladder neck repair

V R Jayanthi1, B M Churchill, A E Khoury

  • 1Division of Urology, Hospital for Sick Children, Toronto, Canada.

The Journal of Urology
|October 23, 1997
PubMed
Summary
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For bilateral single ectopic ureters causing urinary incontinence, bladder neck closure with appendicovesicostomy and augmentation offers the best continence solution. Other outlet resistance procedures showed suboptimal success rates in this patient group.

Area of Science:

  • Pediatric Urology
  • Congenital Abnormalities

Background:

  • Bilateral single ureteral ectopia is a rare congenital anomaly.
  • It is a significant cause of severe urinary incontinence in infants.

Purpose of the Study:

  • To evaluate surgical management outcomes for bilateral single ureteral ectopia.
  • To identify effective strategies for achieving urinary continence in affected patients.

Main Methods:

  • Retrospective review of 7 patients (6 girls, 1 boy) diagnosed with bilateral single ureteral ectopia.
  • Analysis of surgical procedures including ureteral reimplantation, bladder outlet resistance procedures, bladder augmentation, and appendicovesicostomy with bladder neck closure.

Main Results:

  • Initial ureteral reimplantation did not resolve incontinence in 3 patients.

Related Experiment Videos

  • Attempts to increase bladder outlet resistance (Young-Dees-Leadbetter, Kropp, Stamey, Burch, pubovaginal sling) were unsuccessful in achieving continence.
  • Appendicovesicostomy with bladder neck closure, with or without bladder augmentation, resulted in complete continence in all 5 patients who underwent this approach.

    • Conclusions:

    • Total day and nighttime continence for bilateral single ectopic ureters is best achieved through bladder neck closure combined with appendicovesicostomy and bladder augmentation.
    • Procedures solely aimed at increasing bladder outlet resistance are suboptimal for managing this condition, even with concurrent bladder augmentation.