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Query: UMLS:C0403608 (ureter)
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The authors report a 38 years old patient in whom an intravenous pyelogram was performed for moderate arterial hypertension. This showed a large filling defect in the right lower part of the bladder without renal function on that side. Endoscopic separation of the jet coming from the right half of the trigone showed a liquid containing numerous spermatozoa. A cystogram opacified by reflux a cavity in the genital system via this, the right ureter. With the diagnosis of ectopic ureter ending in the genital system, a nephro-ureterectomy demonstrated the attachment of the ureter into a pouch which communicated with the bladder and the seminal vesicle. A view of the normal embryology insists on the fact that contrary to the classic view, the pronephros disappears entirely and that the metanephros is at the origin of the Woffian canal which opens on the posterior wall of the urogenital sinus at the 28th day when the ureter springs from a ureteral bud. Since 1960 this would be the 34th case in the literature, seminal ectopia (24%) coming after ectopia in the prostatic urethra (54%). Epididymitis is a frequent presenting symptom (44%). The workup shows: absence of renal function (100%), raising of the ipsilateral trigone by a cystic swelling (76%), absence of the meatus on that side on endoscopy, presence of an ipsilateral mass above the prostate on rectal examination (30%). The diagnosis is confirmed by vasography where the ureter is opacified by the seminal vesicle or by systography after endoscopic incision of the mass. Excision of the seminal vesicle was done in conjunction with total nephroureterectomy in 17% of cases.
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PMID:[Ectopic ureter ending in the seminal vesicle in adults. Apropos of a case and review of the literature]. 48 Apr 13

A 13 years old boy with a 2 year history recurrent rightsided epididymitis was found to have an ectopic orifice of the vas deferens opening into the distal part of the left ureter of a hypoplastic left kidney. Because of possible interference with fertility vasovesiculography was not done. Therefore it could not be identified whether the vas deferens was of right or left sided origin. The genesis of this extremely rare malformation is discussed.
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PMID:[Ectopia of vas deferens with opening into the ureter (author's transl)]. 49 51

Congenital drainage of the vas deferens into a ureter permits retrograde passage of urine through the vas to the epididymis. If this anomaly is accompanied by urinary tract pathology with vesicoureteral reflux, hydroureter, stasis, and infection, the passage of urine into the vas can very well lead to epididymitis of a chronic or recurring nature and secondary scrotal abscesses. Two cases of this rare anomalous connection are presented in which such scrotal infections occurred. The diagnosis should be suspected on clinical grounds and can be confirmed by cystograms in which the dye refluxes up the ureter and passes into the vas. The association of rectal anomalies is of embryologic significance and may be additionally important clinically by further suggesting the possibility of the ureteral-vas anomaly.
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PMID:Congenital vas deferens--ureteral connection. 63 54

A significant number of ureters with ectopic insertion occur in the single (nonduplex) collecting system. We have investigated 16 patients with this anomaly whose ureters were abnormal enough to cause problems. Characteristic symptoms at presentation included a pelvic mass, ureterovesical obstruction, a ureterocele, urinary dribbling, epididymitis, and infection of the urinary tract with or without reflux. Radiographic evaluation is usually possible using only intravenous urogarphy and voiding cystourethrography. Nonvisualization of one kidney in association with one of the above findings should suggest a single ectopic ureter. Particular attention should be paid to the site of ureteral insertion whenever reflux is seen.
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PMID:The single ectopic ureter. 99 31

A 83-year-old man was admitted because of fever and painful swelling of the right scrotal contents on January 23, 1989. Kidney-ureter-bladder X-ray (KUB) showed multiple big prostatic calculi which were compressed postero-laterally by benign prostate hyperplasia (BPH) according to the CT film. UCG film revealed urethral stricture in the anterior urethra. He was diagnosed as having right epididymitis, urethral stricture, BPH and giant prostatic calculi. He was treated with right orchiectomy, urethral bougie and suprapubic prostatectomy with removal of the calculi. The total weight of the prostatic calculi was 28 g of consisted of 125 pieces. The postoperative course was uneventful and two years after the operation he has been well and free from evident disease.
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PMID:[A case of giant prostatic calculi]. 138 68

A 30-year-old man was admitted to our hospital suffering from fever and left scrotal swelling. Physical examination revealed an enlarged left epididymis, suggesting acute epididymitis. Intravenous pyelography showed non-functioning left kidney. On cystoscopy, the left ureter orifice did not open in the bladder, and it opened in the posterior urethra. An ureteral catheter was passed through this orifice to about 5 cm length and retrograde injection of contrast material demonstrated a dilated left ureter. CT also confirmed a dilated left ureter behind the bladder and the left kidney was not found. Left nephroureterectomy was performed. Microscopically, normal renal tissue was not recognized, and the lesion comprised a number of ducts covered with tall columnar epithelium having stereocilia and ducts resembling the thyroid gland. The former ducts resembled the ducts of epididymis. The pathological diagnosis was total dysplasia.
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PMID:[A case of ectopic ureter with renal dysplasia simulating epididymal structure]. 152 18

The ectopic ureter is less common in male than in female patients. It usually terminates proximally to the external sphincter in the seminal vesicle or vas deferens, and usually involves a nonduplicated drainage system of a dysplastic kidney. Men characteristically present with lower tract symptoms, often epididymitis, a cystic or boggy periprostatic mass on rectal examination and ipsilateral nonvisualization on excretory urography. The embryology, pathogenesis, diagnosis and treatment of this condition are discussed, and 4 illustrative cases are presented.
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PMID:The ectopic ureter in men. 352 21

A thirty-two-year-old man presented with a history of infertility, recurrent epididymitis, and a fluctuant pelvic mass on rectal examination. Preoperative evaluation disclosed a nonvisualized right kidney and a multiloculated cystic lesion in the pelvis. The intravenous pyelogram suggested a ureterocele on the right side. A cystic pelvic mass was noted on ultrasound and computed tomography. A dysplastic right kidney with an ectopic ureter inserting into a cystic seminal vesicle was found at surgical exploration.
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PMID:Ureteral ectopia presenting as epididymitis and infertility. 360 13

It is reported on the very rare clinical picture of a unilateral ectopy of the ureter in the male sex. Since about one third of all infantile malformations are of urological nature in the occurrence of a relapsing epididymitis/orchitis in childhood and adolescence, connected with the rectal palpation findings of a soft cell in the region of prostate gland and seminal vesicle which can be squeezed out, should be thought of such a clinical picture. An early recognition in good time prevents an atrophy of testicle and epididymitis or even their loss, connected with later infertility.
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PMID:[Unilateral external ectopia of the male monoureter]. 378 4

We report 5 cases of an ectopic ureter opening into the seminal tract. All of the patients presented with the clinical features of acute or chronic epididymitis. Our experience has shown that the rare occurrence of epididymitis in prepubertal children necessitates a complete urological evaluation and that an underlying urological problem, including an ectopic ureter, should be sought.
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PMID:Ectopic ureter presenting with epididymitis in childhood: report of 5 cases. 400 6


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