Ectopic Ureter: Let's talk about it simply

Does your little one get frequent urinary tract infections (UTIs)? Or does he or she urinate on his or her clothes without even realizing it? Sometimes we think these are normal things, but there could be a small structural problem behind this that is present from birth. That is what we are going to talk about today. This is called an ectopic ureter. Don't worry, we will explain everything about this in simple terms.

What exactly is an Ectopic Ureter?

Simply put, this is a congenital condition. We have two kidneys in our body. These kidneys filter the waste products in our body and produce urine (pee). The urine that is produced in this way is carried to the urinary bladder through two thin tubes. These two tubes are called ureters . Usually, there is one ureter per kidney, both of which are directly connected to the bladder.

However, in the case of 'ectopic ureter', one (or possibly both) of these ureteral tubes connects to the bladder in the wrong place instead of connecting to it.

Think of it like a road taking a wrong turn. There are several places where you can make a wrong connection like this:

• Urethra (the tube that carries urine from the bladder)
• Bladder neck
• Rectum
• In women, the uterus, cervix, or vagina
• In men, the sperm ducts

This condition is often seen with a condition called a 'duplex kidney' . This means that two ureters are connected to the same kidney. Then, one of the two tubes is often connected in the wrong place.

What are the symptoms of this condition?

One reason this condition can be difficult to diagnose is that its symptoms are similar to those of other common illnesses, such as urinary tract infections (UTIs). However, if the following symptoms persist, you should be concerned.

Is this a painful condition?

The condition called 'ectopic ureter' itself is not painful. However, the side effects that it causes can be painful. For example:

• Inflammation and pain caused by urinary tract infections (UTIs).
• Infection and inflammation of the testicles in men (Epididymitis).
• Prostate infection (Prostatitis).

Why is this happening? Who is most at risk?

Doctors don't really know the exact cause of this. It's caused by a very small change in the development of the urinary system as a baby grows in the womb. This is not due to any mistake on the part of the mother during pregnancy.

However, there are groups that are at particular risk of developing this condition:

• Girls: Although the reason is not clear, girls are about 10 times more likely to develop this condition than boys.
• Family history: If one of the parents has this condition, there is a small risk that the child will also have it.

How does a doctor find this?

It can be difficult to diagnose because the symptoms are similar to other conditions. Sometimes it is discovered incidentally during a prenatal ultrasound scan while the baby is still in the womb.

Otherwise, when you take your child to the doctor, he will first ask you about the symptoms, examine the child, and then, if there is any doubt about the condition, he will order some special tests to confirm it.

What are you doing as treatment?

The main goal of the surgery is to reconnect the misplaced ureter to its correct position and prevent damage to the kidney. Doctors use several types of surgery for this. The most appropriate surgery is chosen based on the child's condition.

• Ureteroureterostomy: This involves connecting the incorrectly connected ureter to the other correct ureter, creating a Y-shaped connection.
• Ureteral Reimplantation: In this procedure, the misplaced ureteral tube is removed and reattached to the correct location in the bladder.
• Nephrectomy: Sometimes, this problem can cause severe damage to the kidney and severely reduce its function. If the other kidney is perfectly healthy, only as a last resort may it be necessary to remove part of the damaged kidney (partial nephrectomy) or the entire kidney (radical nephrectomy).

This surgery gives very successful results, so there is no need to be unnecessarily afraid of it.

What happens if you don't treat it? What happens after treatment?

If this condition is left untreated, there is a high risk of developing persistent urinary tract infections and, over time, permanent damage to the kidneys .

However, with timely diagnosis and appropriate surgery, the child can live a completely normal life. Many people do not feel any difference. Even if a kidney has to be removed, the remaining kidney becomes strong and continues to function without any problems in the body. However, as the doctor says, it is important to continue to be examined by a kidney specialist (nephrologist).

This condition usually does not affect sexual function or the ability to have children in the future (fertility).

Questions and fears that come to mind as a parent

It's hard to put into words what it feels like to find out that your child has a congenital problem. It's normal to have a thousand questions running through your mind, like, 'Why did this happen to me?', 'Did I do something wrong?'

Even doctors don't know exactly what causes this condition. These are sometimes random things that happen. It's not something you should have done, or something you did wrong. So don't blame yourself.

The most important thing is that once this is diagnosed, the outlook is very good. Treatments are very effective. This will not prevent your child from living a healthy, happy life. Talk to your doctor about any questions or concerns you may have. He or she will explain everything to you.

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