Ectopic ureteric bladder insertion in a non-duplex kidney

Case contributed by Chris O'Donnell
Diagnosis certain


Recurrent urinary tract infections. Right ureteric orifice not seen at cystoscopy.

Patient Data

Age: 60 years
Gender: Male

Single right ureter passing down along the psoas muscle but then coursing anteriorly with the external iliac artery and then hooking back to the bladder entering laterally (arrows) well away from the trigone (as on the left side)

Case Discussion

Ectopic ureters are usually associated with duplex renal collecting systems and can enter the distal bladder, urethra, vagina or perineum.  Single ectopic ureters are rare and lateral bladder wall insertions are also very uncommon leading to surgical difficulties.  It is of dubious significance with regard to recurrent UTI.  The main differential diagnosis for this finding is ureteric re-implantation in patients with distal ureteric injury/stricture (usually with a bladder "hitch").

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