In complete duplication of ureters Proximal segment?
Correct Answer: Cephalad and Medial
Description: Ans. (c) Cephalad and medialRef Bailey and Love 26th Edition, Page 1286* Ectopic ureters are usually associated with duplicate ureters (in 80% cases) but may also occur in single ureters systems* More common in females* In the male, the posterior urethra is the most common site of termination of an ectopic ureter.Weigert - Meyer rule of Ectopic ureters:# Weigert Meyer rule states that upper pole ureter is the ectopic ureter and its orifice inserts inferomedially in bladder in relationship to the lower pole normal ureter.# The ureter of the upper pole moiety obstructs. The upper pole ureter is usually obstructed resulting in ureterocele and forms hydronephrosis of corresponding renal pelvis.# The ureter of the lower pole moiety refluxes. The lower pole ureter relaxes at its level often causes pyelonephritis# In a male patients the ectopic ureters opens always above the external urethral sphincter (the bulbar urethra is below the external urethral sphincter)# In females patient ectopic ureters may open above or below the external urethral sphincterMost common symptom# In males -- recurrent UTI# In females -- incontinence (paradoxical incontinence)# Ectopic opening below the external urethral sphincter leads to urinary incontinence: "continuous incontinence in a girl with an otherwise normal voiding pattern after toilet training is the classic symptom of an ectopic ureteral orifice"# Treatment: Reimplantation of ureter is done, if kidney is scarred
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