Ectopic Ureter Repair

The bladder is approached through a caudal abdominal midline incision extending from the umbilicus to the pelvic brim. The bladder is exteriorized with an apex stay suture and a ventral cystotomy extending down through the dorsally located trigone and onto the proximal urethra. The incision extends beyond the opening of the normal ureteral orifice. The abnormal ureter is palpated as it runs within the bladder wall into the urethra. A small mucosal linear incision is made over the palpated ureter where you want it to open (across from the normal opening). The ureter is isolated and ligated distally and transected. The proximal opening is spatulated and anastamosed to the surrounding bladder mucosa with simple interrupted 5-0 absorpable suture material. The bladder is closed with simple interrupted sutures. The rule is 50-25-25 (cure-improvement-no improvement). An alpha receptor stimulating drug (phenylpropenolamine) can improve the results obtained.