Urinary Incontinence in Adulthood in a Course of Ectopic Ureter—Description of Two Clinical Cases with Review of Literature

Kuliniec, Iga; Mitura, Przemysław; Płaza, Paweł; Widz, Damian; Sudoł, Damian; Godzisz, Michał; Kołodyńska, Aleksandra; Monist, Marta; Wisz, Agata; Bar, Krzysztof

doi:10.3390/ijerph18137084

Cited by 9 publications

(11 citation statements)

References 24 publications

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“…It is a result of partial or total duplication of the ureteric bud. Depending on the degree of fusion, it can present as bifid renal pelvis, partial (incomplete) ureteric duplication with ureters joining proximally or near the bladder wall and complete ureteric duplication with separate ureteric orifices [7,8]. In complete duplex, the ureteral drainage pattern is normally governed by the Meyer-Weigert rule, predicting that the ureter of the upper part usually drains infero-medially into an ectopic location, and the lower ureter part usually drains supero-laterally to its normal insertion in the trigon [9,10].…”

Section: Discussionmentioning

confidence: 99%

Multi Imaging Modality in Diagnosis of Unusual Giant Hydronephrosis of the Non Functioning Lower Moiety in A Partial Duplex Kidney with Distal Ureteric Stricture

TawfeeqI¹,

D²,

S³

2022

Int J Radiol Imaging Technol

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Duplex collecting system of the kidney is a common congenital anomaly of the urinary tract. It is usually asymptomatic clinically with normal renal function. In rare instances, it may complicate with giant hydronephrosis. The following is a case of a middle aged woman with history of recurrent urinary tract infections (UTI) and flank pain diagnosed with bilateral partial duplex kidney complicated with unusual non-functioning lower moiety left giant hydronephrosis due to distal left ureteric stenosis which probably enhanced the reverse flow of urine together with YO-YO reflux. The left upper moiety was preserved and functioning. There was also right bifid ureter seen (Y Shaped). Advanced cross sectional imaging modalities has simplified the diagnosis of this condition. CaSe RepoRT Check for updatesOn radiological examination, ultra-sonogram of the abdomen revealed a large left side intra-abdominal cystic lesion occupying the left hemi-abdomen pushing the bowel and other solid organs to the right side.Computed Tomography Urography (CTU) with delayed images showed bilateral partialrenal duplex kidney. The right kidney appeared as partial duplex

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Section: Discussionmentioning

confidence: 99%

Multi Imaging Modality in Diagnosis of Unusual Giant Hydronephrosis of the Non Functioning Lower Moiety in A Partial Duplex Kidney with Distal Ureteric Stricture

TawfeeqI¹,

D²,

S³

2022

Int J Radiol Imaging Technol

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“…The diagnosis of the ectopic ureter was easily missed due to its rare incidence. Urinary incontinence, manifested as persistent wetness of the underwear or urine leakage, was a common symptom of an ectopic ureter with vaginal insertion in women [ 7 ]. Case 3 and Case 4 presented urinary incontinence requiring a sanitary pad.…”

Section: Discussionmentioning

confidence: 99%

“…The developmental disorders of the urinary system throughout embryogenesis contribute to the ectopic ureter mechanisms [ 7 ]. Although the exact mechanisms of ectopic ureter remain unclear, the complex process depends on precise cellular signaling pathways and the integration of diverse progenitor cell types.…”

Section: Discussionmentioning

confidence: 99%

“…Various imaging tests, including magnetic resonance imaging (MRI), computed tomography (CT), and urography, are applied to demonstrate the malformations. However, the detection rate and diagnostic value of each imaging test are still uncertain [ 2 , 5 , 7 ]. Geographical differences exist in the prevalence of ectopic ureters in a single collecting system [ 3 , 8 ], and the cellular and molecular mechanisms generating ureter abnormalities are not fully understood [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

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Gynecological Diagnosis and Treatment of Ectopic Ureter Insertion into Vagina: Analysis of Five Cases and a Literature Review

Wang

Wu²,

Zhang³

et al. 2022

JCM

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An ectopic ureter is a ureter that does not correctly connect to the trigone of the bladder and drains outside of the bladder. Here, we presented five cases of ectopic ureter opening into the vagina, whose clinical symptoms and malformations were rarely described in previous case reports. All five patients were hospitalized with complaints of gynecologic disease. Three of the five cases did not present the typical symptoms of urinary incontinence. Three of these cases showed congenital malformations of the female genital tract. Four cases were diagnosed in adulthood. All patients were analyzed using various imaging examinations. This study suggests that the ectopic ureter should be considered in the differential diagnosis of a pelvic mass in a patient with urinary and reproductive system abnormalities. It is essential to comprehensively evaluate complex malformations of the genitourinary system with multiple imaging tests.

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“…A tortuous ureter is often described in imaging studies and might suggest a ureteroinguinal hernia associated with the patient’s clinical picture. Tortuous ureters are usually found in ectopic kidneys [ 52 , 53 ], the majority being situated lower, in the pelvis [ 54 ], with an incidence up to 1 in 3000 cases, caused by an incomplete ascent of the kidney during the embryonic period. Thus, ultrasound findings of renal ectopia with tortuous ureters are predisposed to ureteral herniation [ 55 ].…”

Section: Introductionmentioning

confidence: 99%

Difficulties in Diagnosing Extraperitoneal Ureteroinguinal Hernias: A Review of the Literature and Clinical Experience of a Rare Encounter in Acute Surgical Care Settings

et al. 2022

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Although inguinal hernia repair is one of the most common surgical procedures, finding a retroperitoneal structure, such as the ureter, is a rather rare occurrence. Ureteroinguinal hernias may arise in the presence or absence of obstructive uropathy, the latter raising difficulties in diagnosis for the general surgeon performing a regular inguinal hernia surgery. This study aims to collect the relevant literature describing the diagnosis and management of ureteroinguinal hernias and update it with a case encountered in our clinic. The following study was reported following the SCARE guidelines. The relevant literature describes less than 150 cases of ureteroinguinal hernias overall, considering the 1.7% prevalence of inguinal hernias in the general population. With only 20% of these hernias being described as extraperitoneal, such an encounter becomes an extremely rare finding. Our clinical experience brings a case of a 75-year-old male with frequent urinary tract infections and a large irreducible inguinoscrotal hernia of about 20/12 cm located at the right scrotum. The patient underwent an open inguinal hernia repair technique under general anesthesia, incidentally finding an extraperitoneal ureteral herniation. Segmental ureterectomy was performed with uneventful recovery. Intraoperatively, finding an incidental ureteroinguinal hernia raises concerns about probable urinary tract complications during regular hernia repair surgery and whether the diagnosis is likely to happen prior to surgical intervention. Although imaging is rarely indicated in inguinal hernias, the case reports show that a pelvic CT scan with urography in symptomatic patients with urinary symptoms will provide accurate confirmation of the diagnosis. The relevant literature is limited due to the rarity of respective cases, thus making standardized management of such cases unlikely.

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Urinary Incontinence in Adulthood in a Course of Ectopic Ureter—Description of Two Clinical Cases with Review of Literature

Cited by 9 publications

References 24 publications

Multi Imaging Modality in Diagnosis of Unusual Giant Hydronephrosis of the Non Functioning Lower Moiety in A Partial Duplex Kidney with Distal Ureteric Stricture

Multi Imaging Modality in Diagnosis of Unusual Giant Hydronephrosis of the Non Functioning Lower Moiety in A Partial Duplex Kidney with Distal Ureteric Stricture

Gynecological Diagnosis and Treatment of Ectopic Ureter Insertion into Vagina: Analysis of Five Cases and a Literature Review

Difficulties in Diagnosing Extraperitoneal Ureteroinguinal Hernias: A Review of the Literature and Clinical Experience of a Rare Encounter in Acute Surgical Care Settings

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