Ectopic ureter

The Harnleiterektopie or ectopic ureter is a congenital malformation of the ureter, which occurs mainly in dogs and there seems to be hereditary in some breeds. Females are much more frequently affected than males.

Pathophysiology

In a healthy dog, the ureter open within the trigone of the bladder ( bladder triangle) into the urinary bladder where the urine is retained until the micturition through the urethral muscle. Harnleiterektopie at the mouth of one or both ureter is below this sphincter, and takes opens into the urinary bladder into the urethra, the vagina or the uterus. Because the urine can not be retained, there is urinary incontinence, which is expressed in constant light dribbling. Complications included local skin irritation and urinary tract infections rising may occur.

Clinic

Signalment

The disease occurs in Norwegian Elchhunden, Siberian Huskies, Newfoundlands, Golden and Labrador Retrievers, West Highland White Terrier, Fox Terrier and Miniature Poodles on frequently, but can occur sporadically in all races. Females are eight times more likely to be affected as males. Most cases are presented between the ages of three and six months.

Symptoms

The main symptom of urinary incontinence is Harnleiterektopie with constant dribbling. Animals with a normal and ectopic ureter show additionally normal Harnabsatzverhalten while animals with ectopic ureters on both sides can not urinate normally. The constant dribbling can cause skin irritations and infections of the vagina and vulva, can ascend to the kidneys in females.

Males less likely to develop symptoms because they can compensate for the circumvention of M. urethralis normally through the sphincter urethrae internus, which covers the entire length of the urethra.

Diagnosis

The diagnosis is made on the injection of a contrast agent into the bloodstream, which is excreted through the kidneys. By means of X-rays may be the way of the contrast agent through the kidney and ureter be traced to the urinary bladder. If an ectopic ureter present, show the X-ray images of the bladder over the course to its mouth. At the same time, this diagnosis method also allows the representation of any auxiliary abnormalities in the urinary tract, such as hydronephrosis.

Treatment and prognosis

A curative treatment is surgery. In a one-sided Harnleiterektopie nephrectomy of the affected kidney can be performed, especially when complications such as hydronephrosis or pyelonephritis are available. With a two-sided Harnleiterektopie the treatment of choice is a transplant of ectopic ureteral orifices in the bladder, creating a functionally normal situation can be achieved in the urinary tract. Transplantation is also possible with unilateral ectopia, if the kidney on the affected side is normal.

With a two-sided Harnleiterektopie and in a unilateral ectopia with a not entirely healthy contralateral kidney nephrectomy is contraindicated. In such cases, the treatment of the transplant is the ectopic ureteral orifice into the bladder.

In mild cases, urinary incontinence can be treated symptomatically, eg by administering phenylpropanolamine or ephedrine.

A successful surgical treatment, the prognosis is good. Occasionally, complications such as persistent urinary incontinence or dysuria as well as hydronephrosis.

Genetics and breeding hygiene

The inheritance of Harnleiterektopie in dogs is unknown, probably it is a polygenic disease. Affected dogs should not be used for breeding; Matings from which emerged puppies with Harnleiterektopie, should not be repeated.