Bilateral single ureteral ectopia: difficulty attaining continence using standard bladder neck repair.
OBJECTIVE
We reviewed the surgical results of the management of bilateral single ureteral ectopia, a rare congenital cause of severe urinary incontinence.


METHODS
We reviewed the records of 6 girls and 1 male infant who presented to 1 institution with this diagnosis in a 10-year period.


RESULTS
All patients were incontinent and 3 had undergone ureteral reimplantation as an initial procedure with persistent postoperative wetting. Of the 5 patients who underwent a total of 8 attempts at increasing bladder outlet resistance, including 3 Young-Dees-Leadbetter, 2 Kropp, 1 Stamey, 1 Burch and 1 pubovaginal sling procedure, 2 also underwent simultaneous bladder augmentation to increase bladder capacity. However, none of these children had satisfactory continence after the continence procedure. Three of these patients who subsequently underwent appendicovesicostomy with bladder neck closure are continent. The 2 remaining patients underwent initial appendicovesicostomy with bladder neck closure and augmentation, and they are also continent.


CONCLUSIONS
In our series total day and nighttime continence was only achieved by bladder neck closure, appendicovesicostomy and augmentation. Attempts at increasing bladder outlet resistance in patients with bilateral single ectopic ureters led to suboptimal rates of success even when adequate bladder capacity had been ensured by simultaneous augmentation.
Jayanthi
V R
VR
Division of Urology, Hospital for Sick Children, Toronto, Canada.
Churchill
B M
BM
Khoury
A E
AE
McLorie
G A
GA
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D014513:Ureter / Q000002:abnormalities* / Q000601:surgery*; D001743:Urinary Bladder / Q000601:surgery*; D014549:Urinary Incontinence / Q000209:etiology / Q000601:surgery*