Question

Which of the following surgery is/are done in cases of ectopic ureter?
(A) Neouretereostomy
(B) Ureteroneocystostomy
(C) Urethrostomy
(D) Cystostomy
Choose the correct answer from the options given below:

• A. (A) and (C) only.
• B. (A) and (B) only.
• C. (B) and (C) only.
• D. (A), (B) and (D) only.

Hint:

- Intramural Ectopic Ureter $\rightarrow$ Corrected via Neoureterostomy (creating a new opening inside the bladder wall).
- Extramural Ectopic Ureter $\rightarrow$ Corrected via Ureteroneocystostomy (re-implanting the cut ureter into the bladder wall).

Answer 1

The Correct Option is B

Step 1: Understanding the Concept:
An ectopic ureter is a congenital anatomical anomaly where one or both ureters bypass the urinary bladder trigone and empty abnormally into the urethra, vagina, or uterus, leading to urinary incontinence.
Surgical correction is required to redirect the ureteral opening into the urinary bladder.

Step 2: Detailed Explanation:
Surgical management depends on whether the ectopic ureter is intramural (running within the bladder wall before opening distally) or extramural (completely bypassing the bladder to enter the urethra/vagina):
- (A) Neoureterostomy:
This procedure is performed for intramural ectopic ureters.
An incision is made through the bladder mucosa into the ureteral lumen at the level of the bladder trigone, creating a new, anatomically correct stoma (opening) within the bladder, while the distal ectopic portion of the ureter is ligated.
Therefore, (A) is used.
- (B) Ureteroneocystostomy:
This procedure is performed for extramural ectopic ureters.
The abnormally terminating ureter is transected near its distal attachment, moved, and re-implanted through a new incision in the urinary bladder wall (trigone), creating a new opening.
Therefore, (B) is used.
- (C) Urethrostomy:
This is the creation of a permanent external opening in the urethra (such as perineal urethrostomy in male cats with blocked urethras) and is not used to correct ectopic ureters.
- (D) Cystostomy:
This is the placement of a temporary or permanent drainage tube into the bladder (usually for urinary diversion) and is not the definitive corrective surgery for an ectopic ureter.
Thus, Neoureterostomy (A) and Ureteroneocystostomy (B) are the surgical procedures used to correct ectopic ureters.

Step 3: Final Answer:
The correct option is (B), representing (A) and (B) only.