Role of magnetic resonance urography in the diagnosis of single-system ureteral ectopia with congenital renal dysplasia: a tertiary care center experience in India

Joshi, Medha; Parelkar, Sandesh; Shah, Hemanshi; Sanghvi, Beejal; Agrawal, Amit; Mishra, Pankaj

doi:10.1016/j.jpedsurg.2009.01.016

Cited by 17 publications

(12 citation statements)

References 10 publications

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“…In the light of our results, we suggest to perform postnatal US whenever MCDK and pelvic cyst are observed in utero. MRI is particularly useful in case of inconclusive US and provides both urinary anatomical and functional data [14]. Magnetic resonance urography can depict or exclude ectopic ureters in duplex systems [15].…”

Section: Discussionmentioning

confidence: 99%

Prenatal Evaluation and Postnatal Follow-Up of Ureteral Ectopic Insertion in Multicystic Dysplastic Kidneys

Cassart

Majoub²,

Irtan

et al. 2018

Fetal Diagn Ther

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Objective: To emphasize the need for analyzing the pelvis when a unilateral multicystic dysplastic kidney (MCDK) is observed at prenatal ultrasonography (US) because of possible associated ectopic ureteral insertion. Methods: We performed a retrospective study including prenatal US diagnosis of unilateral MCDK and retrovesical cyst. The following data were recorded: pre- and postnatal US, magnetic resonance imaging (MRI), and voiding cystourethrography (VCUG) findings. The shape of the pelvic cyst was analyzed as well as the visibility of the ureteral insertion into the cyst. Results: Fourteen patients were included (7 females). At prenatal US, the cyst wall was smooth in 8 cases (6 females) and lobulated in 5 cases (4 males). In 1 case it protruded into the bladder. Ectopic ureteral insertion was observed in 2 cases. Prenatal MRI (n = 6) depicted ureteral insertion in 2 more cases. Postnatal US (n = 14) showed the same cyst patterns as prenatally, ectopic ureteral insertion (n = 8), and duplicated uterus (n = 4). Postnatal MRI (n = 7) always depicted the ureteral ectopic insertion into the cyst. VCUG (n = 5) showed indirect findings of ectopic ureteral insertion (n = 3). Conclusion: Unilateral MCDK should lead to search for a retrovesical cyst corresponding most commonly to a distended hemivagina or a seminal vesicle. Early diagnosis of this condition leads to better clinical management.

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Section: Discussionmentioning

confidence: 99%

Prenatal Evaluation and Postnatal Follow-Up of Ureteral Ectopic Insertion in Multicystic Dysplastic Kidneys

Cassart

Majoub²,

Irtan

et al. 2018

Fetal Diagn Ther

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“…Milind et al 5 have concluded that MR urography is an excellent and single best investigation for preoperative diagnosis of a single system ectopic associated with congenital renal hypoplasia. Chowdhary et al 1 suggest that among all investigations available, endoscopic examination of the urethra, bladder and vagina provides most important clue to the diagnosis.…”

Section: Discussion:-mentioning

confidence: 99%

A Case of Bilateral Singleton Ectopic Ureters With Urogenital Sinus – A Rare Entity and Its Innovative Management.

Nage¹,

ijar²

2018

IJAR

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“…In a study performed in India, Joshi et al 7 reported seven cases of congenital renal dysplasia with single-system ureteral ectopia that were correctly diagnosed by preoperative MR urography, which was found to have 100% sensitivity and specificity for diagnosis of kidney dysplasia and determination of the course of the ureters.…”

Section: Discussionmentioning

confidence: 99%

Vaginal ectopic ureter diagnosed by magnetic resonance imaging in a child with complete transverse vaginal septum and hydrocolpos

Lucena¹,

Duarte²,

Takamatu³

et al. 2014

cbr

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Ectopic ureter draining into the vagina is a rare cause of urinary incontinence. Some cases have been reported in association with malformations of the genitourinary tract, but very few published cases are associated with vaginal septum. Our article describes the case of a girl who presented with hydrocolpos shortly after birth and was found to have a complete transverse vaginal septum. Despite successful correction of this genital anomaly, the patient developed persistent dribbling of clear fluid from the genital area. Extensive testing revealed unilateral kidney dysplasia and probable genital ectopia of the corresponding ureter. Magnetic resonance imaging (MRI) showed insertion of the ureter into the upper third of the vagina. The patient underwent nephroureterectomy of the dysplastic kidney with subsequent improvement in urinary incontinence. Ureteral ectopia is difficult to diagnose with conventional imaging methods (plain radiography, ultrasound, and CT). MRI has proved to be an excellent method for assessment of genitourinary tract conditions, particularly when other diagnostic modalities have failed or are limited, due to the high resolution of MRI scans and the possibility of native image acquisition on all three orthogonal planes. MRI is the best diagnostic modality for visualization of the course and insertion of ectopic ureters, and enables precise surgical correction. Keywords: Congenital vaginal ectopic ureter; magnetic resonance imaging; hydrocolpos CASE REPORTA 4-year-old girl presented with a history of intermittent leakage of clear fluid from the genital region. Shortly after birth, she developed a large hydrocolpos causing bilateral ureterohydronephrosis and lower limb edema, and was diagnosed with transverse vaginal septum and a multicystic dysplastic and ectopic right kidney (renal pelvis). On that occasion, drainage and placement of a uterine stoma improved venous and urinary flow. At 10 months, open correction of the vaginal septum and closure of the uterine stoma were performed. After this procedure, the patient developed intermittent dribbling of clear fluid, identical in appearance and odor to urine, from the genital area.A wide variety of diagnostic tests (including ultrasound, computed tomography [CT], cystoscopy, and vaginoscopy) were performed, but failed to confirm the hypothesis of ectopic ureter draining the dysplastic right kidney. At the age of 3, the patient was found to have frequent dribbling of urine during diaper changes despite adequate sphincter control. Physical examination revealed passage of fluid droplets through the vaginal introitus, and she was referred for further radiological assessment. A radionuclide kidney scan showed 48% renal function on the left and complete absence of right kidney function. Dynamic ultrasound examination of the bladder revealed a small amount of fluid in the vagina, which did not coincide with urge to urinate or with recent voiding. Transperineal color Doppler imaging showed discharge of urine into the vagina, suggesting right kidn...

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Role of magnetic resonance urography in the diagnosis of single-system ureteral ectopia with congenital renal dysplasia: a tertiary care center experience in India

Cited by 17 publications

References 10 publications

Prenatal Evaluation and Postnatal Follow-Up of Ureteral Ectopic Insertion in Multicystic Dysplastic Kidneys

Prenatal Evaluation and Postnatal Follow-Up of Ureteral Ectopic Insertion in Multicystic Dysplastic Kidneys

A Case of Bilateral Singleton Ectopic Ureters With Urogenital Sinus – A Rare Entity and Its Innovative Management.

Vaginal ectopic ureter diagnosed by magnetic resonance imaging in a child with complete transverse vaginal septum and hydrocolpos

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