Purpose: To study diagnostic problems encountered by physicians and radiologists in adult females with ureteral ectopia into the urethra. CASE MATERIAL AND METHODS: Retrospective study of 17 localizations in 16 women, 15 to 65 years of age at the time of the definitive diagnosis of duplication of the ipsilateral urinary tract, the ectopia being connected to the upper pelvicalyceal system.
Results: Radiological confirmation of the diagnosis had been obtained in 14 cases. The ectopic ureter was thin in 11 cases. In 5 of 6 cases with megaureter, the distension involved only the distal intrapelvic part of the ureter. The ectopic meatus was juxta-cervical in 5 cases, much lower in the other cases. Of the 11 cases investigated by intravenous urography, 8 exhibited severe monocalyceal hydronephrosis of the upper pelvis whereas 6 upper pelvicalyceal systems were dysplastic. The lower pelvicalyceal system was congenitally normal in all cases.
Conclusion: Most of the false negative diagnoses of intra-urethral ectopic ureter in adult female result from technically inadequate permicturating urethrocystography. The diagnosis should be evoked, especially in women with recurrent cystitis, on the urographic association of: duplication of the upper urinary tract, dysplastic or chronically distended atrophied upper pelvicalyceal system, pseudo-normal architecture of the lower pelvicalyceal system because of the unusually developed "upper" calyx.