Presentation
Came for routine ultrasound checkup. Ultrasound revealed gross left hydroureteronephrosis.
Patient Data
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CECT abdomen and pelvis revealed
Gross left hydronephrosis noted with thinning of renal parenchyma. Poor excretion of contrast in the delayed phase. Left ureter is markedly dilated with a tortuous course. The ureter is seen extending into the pelvis at the region of prostate. Left seminal vesicle is not visualized separately - likely ectopic insertion of ureter into the seminal vesicle.
Lobulated outline of right kidney noted, predominantly in the center of the renal segment about the calyces – scarred right kidney. Few calculi noted.
Gall bladder – solitary calculus noted. Calcifications noted in the wall – suggestive of porcelain gall bladder.
Case Discussion
Ectopic insertion of ureter is defined as the ureteral opening inferior to the trigone of urinary bladder. Ectopic insertion of the ureter of a single collecting system is rare. Usually associated with duplicated systems and involves the upper moiety ureter. In males, the ureter inserts into the prostatic urethra, seminal vesicle, ejaculatory ducts or vas deferens. In females, common insertions are urethra and vaginal vestibule. CT or MR urogram allows the identification of the ectopic ureter.