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How is Ectopic Ureter Diagnosed?

It is most often found in children, and how it is found depends on how the problem first shows up. This issue is not always easy to pinpoint. Other problems have similar signs, so sometimes it is not correctly diagnosed for years.

If the doctor thinks there may be an ectopic ureter but can’t see it at first, then other tests may be done for a clear diagnosis.

There are some basic tests to see the ureters, kidneys and bladder are:

Ultrasound

  • If the ultrasound before birth shows swelling, then the test is often done again after the child is born.

Bladder X-ray (Voiding Cystourethrogram, or VCUG)

  • This test is then done to rule out VUR as the cause of the swelling of the kidney and ureter. This test is also used to see if there is reflux in a second ureter linked to the ectopic ureter.

Renal Flow Scan (MAG-3 or DMSA) or Magnetic Resonance Urogram

  • The kidney or part of the kidney drained by the ectopic ureter often doesn’t work well. In these tests, contrast dye liquid is injected. A special camera is used to spot radioactivity in the dye. MRI (magnetic resonance imaging) can also be used.

Cystoscopy

  • In this test, often done with general anesthesia, a small scope is placed into the urethra. The openings of the ureters from both kidneys are found. X-ray liquid dye is injected through tubes placed temporarily in the ureters to show the anatomy. Unfortunately, the opening of the ectopic ureter cannot always be seen. But by pinpointing the number and location of the other ureteral openings, the doctor can be sure.

But if the ureter is not swollen and there is no reflux, the ultrasound and VCUG may be normal. MRI and CT scan are better at finding slight swelling of the ureter and the part of the kidney it drains.