Weekly News – May Weekly News – May 20102010

URINE INCONTINENCEURINE INCONTINENCE SINGLE ECTOPIC URETER SINGLE ECTOPIC URETER

Presented by: Dr. Pham Presented by: Dr. Pham Ngoc ThachNgoc Thach

KHOA NGOẠI THẬN NIỆU

CLINICAL CASE WITH LEAKAGECLINICAL CASE WITH LEAKAGE

• 6 years old female with chief 6 years old female with chief complain: leakagecomplain: leakage

• History: History: – Traffic accident 2 years ago, injury bony Traffic accident 2 years ago, injury bony

pelvispelvis– Explorative laparotomy and colostomyExplorative laparotomy and colostomy– Post operation: leakage Post operation: leakage neurogenic neurogenic

bladder with CIC, oxybutynine (2 years)bladder with CIC, oxybutynine (2 years)

CHILDREN’S HOSPITAL 2 – Department of Urology

• X-RAYX-RAY • UIVUIV

CHILDREN’S HOSPITAL 2 – Department of Urology

ULTRASOUNDULTRASOUND

CHILDREN’S HOSPITAL 2 – Department of Urology

URO-CTSCANURO-CTSCAN

CHILDREN’S HOSPITAL 2 – Department of Urology

• CYSTOGRAPHYCYSTOGRAPHY • VAGINOGRAPHVAGINOGRAPHYY

CHILDREN’S HOSPITAL 2 – Department of Urology

SURGICAL MANAGEMENTSURGICAL MANAGEMENT

• Vagino- cystoscopy: ectopic ureterVagino- cystoscopy: ectopic ureter• Ureteral re-implantationUreteral re-implantation

CHILDREN’S HOSPITAL 2 – Department of Urology

URINE INCONTINENCEURINE INCONTINENCE

• Trouble bladder movement, psycho Trouble bladder movement, psycho factor…factor…

• Neurogenic bladderNeurogenic bladder• Ectopic ureter, genito-urinary Ectopic ureter, genito-urinary

fistular post trauma…fistular post trauma…

CHILDREN’S HOSPITAL 2 – Department of Urology

SINGLE ECTOPIC URETERSINGLE ECTOPIC URETER

• Incidence: Incidence: 1/20001/2000• Occurring in females Occurring in females 6 times6 times more more

than in malesthan in males• 20%20% ectopic ureter with single system ectopic ureter with single system• 90%90% kidneys / single system do not kidneys / single system do not

functionfunction• Female: Female: incontinenceincontinence• Male: Male: epididymiteepididymite

CHILDREN’S HOSPITAL 2 – Department of Urology

SINGLE ECTOPIC URETERSINGLE ECTOPIC URETER

• UIV, ultrasound, cystography, Uro-CTscan, UIV, ultrasound, cystography, Uro-CTscan, DMSA…DMSA…

• VaginograpyVaginograpy• Cysto-vaginoscopyCysto-vaginoscopy

CHILDREN’S HOSPITAL 2 – Department of Urology

SINGLE

ECTOPIC

URETER

SALVAGEABLE

FUNCTION

REIMPLANTATION

LAPAROSCOPY