An ectopic ureter may initially be seen on ultrasound, either with or without associated renal (hypo)dysplasia. If there is ureteral obstruction, hydroureteronephrosis will be seen. If an ectopic ureter is suspected, highresolution axial imaging or a VCUG can often provide additional information. With females, careful cystoscopy, vaginoscopy, and inspection of the urethrovaginal septum may even provide direct visualization of the ectopic ureteric orifice. In males, careful cystoscopy and examination under anesthesia may also be diagnostic. Once an ectopic ureter has been identified, a renal scan should be performed to assess the function of the associated renal parenchyma.

TREATMENT

Because ectopic ureters are often associated with dysplastic kidneys, the treatment usually consists of nephroureterectomy or, in the case of a duplicated collecting system, heminephrectomy. If, in contrast, the renal parenchyma associated with the ectopic ureter appears to be functional, or if there are bilateral ectopic ureters, ureteropyelostomy or ureteral reimplantation can be performed instead.