SINGLE-SYSTEM URETERAL ECTOPIA - ASSOCIATED MALFORMATIONS AND MANAGEMENT IN CHILDREN LACKING AN ORTHOTOPIC URETER

We present our experience of six children with bilateral single-system ureteral ectopia and two children with unilateral single ectopic uret ers and contralateral renal agenesis. The wide spectrum of malformatio ns indicates an embryological insult in addition to anomalous ureteric buds. There appears to be an element of antenatal ureteral obstructio n affecting some renal units and sparing ectopic contralateral units. Ureteric reimplantation into the embryologically diverted bladder, wit hout additional bladder neck surgery or augmentation, resulted in a sa tisfactory outcome in the majority of cases. Reimplantation techniques may require modification when the bladder is very small, and a simple ureteric nipple has proven effective in preventing reflux.