Ectopic ureter

An ectopic ureter is when the ureter doesn’t connect to the bladder in the usual place. Instead, it can connect into different places, such as the vagina or the urethra (the urine tube that runs from the bladder and out of the body). This often causes urine to build up as it cannot drain like it should. This can lead to problems such as ureteral enlargement, where the ureter swells up.

Ectopic ureters can increase the risk of UTIs or urinary incontinence (uncontrolled loss of urine).

How common are ectopic ureters?

Ectopic ureter is a rare condition that affects around 10 out of 19,000 children. It is more commonly diagnosed in girls, because it tends to have a larger impact on their health and wellbeing. For instance, in girls, the ectopic ureter can connect to an unusual location, such as the vagina and can result in urinary incontinence. 

An ectopic ureter is also more frequently seen in children who have duplex kidney. In some cases, children with an ectopic ureter may not experience any symptoms at all, making it challenging to determine the actual number of children with the condition.

Duplex kidney occurs when a child has 2 ureters connected to a single kidney, instead of one ureter. The extra ureter may be completely separate (called complete duplication), or start separately but combine to create a single tube that attaches to the bladder (called incomplete duplication). 

What are the symptoms of ectopic ureters?

Many children with ectopic ureters don’t experience any symptoms at all, but for those children who do, Urinary Tract Infections (UTIs) and urinary incontinence are known symptoms of the condition.

The type of treatments that are offered depend on the specific condition, your child’s age, overall symptoms, urine flow, kidney function and medical history.

Ureteral re-implantation 

This surgery is performed when ectopic ureters are causing significant complications. 

The surgeon makes a small cut in the lower abdomen to access the bladder and carefully detaches the affected ureter from the bladder and moves it to a new location to improve the flow of urine from the kidneys to the bladder and prevent any blockages or urine reflux. 

Heminephro-ureterectomy (only in duplex kidney) 

A heminephro-ureterectomy is an operation to remove part of the kidney and one of the ureters, if the kidney and ureter are not functioning properly. The aim of surgery is to improve how the kidney works and prevent any further complications. 

During the procedure, the surgeon makes a small cut in the abdomen or side of the body to access the kidney. They identify and remove the part of the kidney that is causing problems, as well as the ureter connected to it. 

Ureteroureterostomy (only in duplex kidney) 

If an ectopic ureter is causing problems by draining urine into the urethra, reproductive organs, or other areas, your doctor may recommend a ureteroureterostomy. This procedure involves the surgeon connecting the 2 ends of the same ureter to the correct places, allowing urine to flow properly from the kidney down to the bladder. 

This surgery aims to improve urine drainage, prevent complications and protect the kidney.

This chapter contains general information about ectopic ureter. It is not a substitute for professional medical advice or treatment. Always consult your doctor or healthcare provider for guidance on your individual medical situation.

Last updated: April 2025