Ectopic ureter: Ureteral orifice below normal insertion in trigone; usually associated with duplicated collecting system
Complete duplicated ureter: 2 ureters drain duplex kidney and remain separate down to bladder insertion or beyond
One of ureters is, by definition, ectopic
Incomplete duplicated ureter: 2 ureters drain duplex kidney and join to form single ureter prior to bladder insertion
a.k.a. bifid ureter
IMAGING
General Features
Radiographic Findings
CT Findings
Ultrasonographic Findings
MR Findings
Nuclear Medicine Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Houat AP et al: Congenital anomalies of the upper urinary tract: a comprehensive review. Radiographics. 41(2):462-86, 2021
Calle-Toro JS et al: Morphologic and functional evaluation of duplicated renal collecting systems with MR urography: a descriptive analysis. Clin Imaging. 57:69-76, 2019
Toia B et al: Diagnosis and surgical outcomes of ectopic ureters in adults: a case series and literature review. Neurourol Urodyn. 38(6):1745-50, 2019
Didier RA et al: The duplicated collecting system of the urinary tract: embryology, imaging appearances and clinical considerations. Pediatr Radiol. 47(11):1526-38, 2017
Thotakura P et al: The "nubbin" sign. Abdom Radiol (NY). 41(2):340-1, 2016
Adeb M et al: Magnetic resonance urography in evaluation of duplicated renal collecting systems. Magn Reson Imaging Clin N Am. 21(4):717-30, 2013
Braga LH et al: Ureteral duplication with lower pole ureteropelvic junction obstruction: laparoscopic pyeloureterostomy as alternative to open approach in children. Urology. 73(2):374-6; discussion 376, 2009
Steyaert H et al: Functional ectopic ureter in case of ureteric duplication in children: initial experience with laparoscopic low transperitoneal ureteroureterostomy. J Laparoendosc Adv Surg Tech A. 19(1):S245-7, 2009
Chen CP et al: Prenatal evaluation with magnetic resonance imaging of a giant blind ectopic ureter associated with a duplex kidney. Ultrasound Obstet Gynecol. 31(3):360-2, 2008
Duong DT et al: A case of ectopic dysplastic kidney and ectopic ureter diagnosed by MRI. Nat Clin Pract Urol. 5(11):632-6, 2008
Jain P et al: Uncrossed complete ureteral duplication with dysplastic lower moiety: a violation of the Weigert-Meyer law. J Pediatr Urol. 4(5):404-6, 2008
Lipson JA et al: Subtle renal duplication as an unrecognized cause of childhood incontinence: diagnosis by magnetic resonance urography. J Pediatr Urol. 4(5):398-400, 2008
McGee SM et al: Cystic dysplasia of testis associated with ectopic ureter causing chronic orchalgia. Urology. 73(6):1423.e7-8, 2008
Park BS: Type IV ureteral triplication associated with ipsilateral ureterocele with ureterolithiasis and contralateral duplication with an ectopic ureteral orifice. Int J Urol. 15(11):1022, 2008
Roy Choudhury S et al: Spectrum of ectopic ureters in children. Pediatr Surg Int. 24(7):819-23, 2008
Selli C et al: Robot-assisted removal of a large seminal vesicle cyst with ipsilateral renal agenesis associated with an ectopic ureter and a Müllerian cyst of the vas deferens. Urology. 71(6):1226, 2008
Brehmer B et al: Laparoscopic heminephrectomy and resection of ectopic ureter in an adult. Urol Int. 79(3):280-3, 2007
Croitoru S et al: Duplicated ectopic ureter with vaginal insertion: 3D CT urography with i.v. and percutaneous contrast administration. AJR Am J Roentgenol. 189(5):W272-4, 2007
Hanson GR et al: Diagnosis of ectopic ureter as a cause of urinary incontinence. J Pediatr Urol. 3(1):53-7, 2007
Kraft KH et al: Ten-year-old girl with crossed-fused ectopic kidney and ectopic ureter to vagina. Urology. 70(6):1220-1, 2007
Berrocal T et al: Anomalies of the distal ureter, bladder, and urethra in children: embryologic, radiologic, and pathologic features. Radiographics. 22(5):1139-64, 2002
Zissin R et al: Renal duplication with associated complications in adults: CT findings in 26 cases. Clin Radiol. 56(1):58-63, 2001
Fernbach SK et al: Ureteral duplication and its complications. Radiographics. 17(1):109-27, 1997
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Clinical Issues
TERMINOLOGY
Synonyms
Duplex kidney
Double or bifid ureters
Ureteral ectopia
Definitions
Ectopic ureter: Ureteral orifice below normal insertion in trigone; usually associated with duplicated collecting system
Complete duplicated ureter: 2 ureters drain duplex kidney and remain separate down to bladder insertion or beyond
One of ureters is, by definition, ectopic
Incomplete duplicated ureter: 2 ureters drain duplex kidney and join to form single ureter prior to bladder insertion
a.k.a. bifid ureter
IMAGING
General Features
Radiographic Findings
CT Findings
Ultrasonographic Findings
MR Findings
Nuclear Medicine Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Houat AP et al: Congenital anomalies of the upper urinary tract: a comprehensive review. Radiographics. 41(2):462-86, 2021
Calle-Toro JS et al: Morphologic and functional evaluation of duplicated renal collecting systems with MR urography: a descriptive analysis. Clin Imaging. 57:69-76, 2019
Toia B et al: Diagnosis and surgical outcomes of ectopic ureters in adults: a case series and literature review. Neurourol Urodyn. 38(6):1745-50, 2019
Didier RA et al: The duplicated collecting system of the urinary tract: embryology, imaging appearances and clinical considerations. Pediatr Radiol. 47(11):1526-38, 2017
Thotakura P et al: The "nubbin" sign. Abdom Radiol (NY). 41(2):340-1, 2016
Adeb M et al: Magnetic resonance urography in evaluation of duplicated renal collecting systems. Magn Reson Imaging Clin N Am. 21(4):717-30, 2013
Braga LH et al: Ureteral duplication with lower pole ureteropelvic junction obstruction: laparoscopic pyeloureterostomy as alternative to open approach in children. Urology. 73(2):374-6; discussion 376, 2009
Steyaert H et al: Functional ectopic ureter in case of ureteric duplication in children: initial experience with laparoscopic low transperitoneal ureteroureterostomy. J Laparoendosc Adv Surg Tech A. 19(1):S245-7, 2009
Chen CP et al: Prenatal evaluation with magnetic resonance imaging of a giant blind ectopic ureter associated with a duplex kidney. Ultrasound Obstet Gynecol. 31(3):360-2, 2008
Duong DT et al: A case of ectopic dysplastic kidney and ectopic ureter diagnosed by MRI. Nat Clin Pract Urol. 5(11):632-6, 2008
Jain P et al: Uncrossed complete ureteral duplication with dysplastic lower moiety: a violation of the Weigert-Meyer law. J Pediatr Urol. 4(5):404-6, 2008
Lipson JA et al: Subtle renal duplication as an unrecognized cause of childhood incontinence: diagnosis by magnetic resonance urography. J Pediatr Urol. 4(5):398-400, 2008
McGee SM et al: Cystic dysplasia of testis associated with ectopic ureter causing chronic orchalgia. Urology. 73(6):1423.e7-8, 2008
Park BS: Type IV ureteral triplication associated with ipsilateral ureterocele with ureterolithiasis and contralateral duplication with an ectopic ureteral orifice. Int J Urol. 15(11):1022, 2008
Roy Choudhury S et al: Spectrum of ectopic ureters in children. Pediatr Surg Int. 24(7):819-23, 2008
Selli C et al: Robot-assisted removal of a large seminal vesicle cyst with ipsilateral renal agenesis associated with an ectopic ureter and a Müllerian cyst of the vas deferens. Urology. 71(6):1226, 2008
Brehmer B et al: Laparoscopic heminephrectomy and resection of ectopic ureter in an adult. Urol Int. 79(3):280-3, 2007
Croitoru S et al: Duplicated ectopic ureter with vaginal insertion: 3D CT urography with i.v. and percutaneous contrast administration. AJR Am J Roentgenol. 189(5):W272-4, 2007
Hanson GR et al: Diagnosis of ectopic ureter as a cause of urinary incontinence. J Pediatr Urol. 3(1):53-7, 2007
Kraft KH et al: Ten-year-old girl with crossed-fused ectopic kidney and ectopic ureter to vagina. Urology. 70(6):1220-1, 2007
Berrocal T et al: Anomalies of the distal ureter, bladder, and urethra in children: embryologic, radiologic, and pathologic features. Radiographics. 22(5):1139-64, 2002
Zissin R et al: Renal duplication with associated complications in adults: CT findings in 26 cases. Clin Radiol. 56(1):58-63, 2001
Fernbach SK et al: Ureteral duplication and its complications. Radiographics. 17(1):109-27, 1997
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