**Question:** Classic symptom of ectopic ureter in females

A. Hematuria
B. Hydronephrosis
C. Vesicoureteric reflux
D. Vesicoureteric reflux with fever

**Core Concept:** Ectopic ureter is an anomaly where a ureter fails to descend into the pelvis and instead enters the bladder or another pelvic organ. This leads to abnormal urinary drainage, potentially causing symptoms and complications.

**Why the Correct Answer is Right:** The correct answer, "Hydronephrosis," is a symptom resulting from ectopic ureter. When urine backs up in the dilated renal pelvis due to ectopic ureter's inability to drain properly, it causes hydronephrosis. Hydronephrosis is the clinical manifestation of renal pelvic dilatation, leading to decreased renal function and potential kidney damage.

**Why Each Wrong Option is Incorrect:**

A. Hematuria (blood in urine) is not a classic symptom of ectopic ureter but may occur due to reflux of blood into the urine.

B. Hydronephrosis is a direct consequence of ectopic ureter, not a symptom itself.

C. Vesicoureteric reflux (VUR) is a condition where urine refluxes from the bladder back into the ureter or kidney. It is a potential complication of ectopic ureter but not a symptom.

D. Fever is not a typical symptom of ectopic ureter. Infection (pyelonephritis) can occur as a result of reflux and hydronephrosis, leading to fever. This is not the primary symptom of ectopic ureter itself.

**Clinical Pearl:** The correct answer, hydronephrosis, is a crucial sign of ectopic ureter. In cases of ectopic ureter, the primary cause is the anatomical abnormality, affecting renal function. Hydronephrosis is a downstream consequence of ectopic ureter, highlighting the importance of recognizing and treating the underlying cause to prevent complications like kidney damage and infection.