VSR 421: Regional Veterinary Surgery (2+1)

ECTOPIC URETER

• Ectopic ureter is a congenital anomaly where one or both ureters empty outside the urinary bladder.

Symptoms

• Urinary incontinence
• Pyelonephritis and cystitis
• Hydroureter
• Suspect Ectopia of ureter in any young animal that has a history of incontinence since birth
• Suspect this in older animals with lifelong urinary incontinence
• More commonly diagnosed in female dogs than in males

Diagnosis

• Contrast Radiography
• Ultrasonography

Treatment

• Medical management – aimed at treating the urethral sphincter incompetence. Drugs used are
  • Phenylpropanolamine
  • Ephedrine
  • Imipramine
  • Diethylstlbestrol

Surgical techniques

• It includes the following
• Neoureterostomy – is performed for intramural ectopic ureters where the ureter course submucosally in the bladder and opens into the urethra or vagina. After performing a cystotomy, an incision is made into the ureter to make a stoma into the bladder. This is followed by ligation of the ureter coursing distally to the stoma.
• Ureteroneocystostomy – is performed for extraluminal ectopic ureters where the ureter completely bypasses the bladder. The ureter is first ligated and transected. An new entry for the ureter is then created in the bladder and the transected end of the ureter is then sutured to the bladder mucosa through the newly created bladder incision.