What is an ectopic ureter?
The ureter normally inserts in the trigone of the urinary bladder. If the insertion is at any other site, it is referred to as ectopy. Caudal ectopy (i.e., insertion of the ureter below the trigone) is much more frequent than cranial ectopy (i.e., insertion of the ureter above the trigone). With caudal ectopy, the ureter can insert in the bladder neck, the urethra, or even the vagina in females. In most boys, ureteral ectopy is not associated with incontinence as the ureter almost always inserts above the striated sphincter, which is closed at rest and opens only during voiding. In girls, incontinence of variable severity often occurs with ureteral ectopy as the insertion may be in the vagina or the urethra distal to the sphincter, and necessitates a workup to determine where the ectopic ureter is inserting for appropriate surgical management.