Other important functions of the kidneys include blood pressure regulation and the production of erythropoietin, which controls red blood cell production in the bone marrow. Kidneys also regulate the acid-base balance and conserve fluids. Two kidneys.
This pair of purplish-brown organs is located below the ribs toward the middle of the back. Their function is to:. The kidneys remove urea from the blood through tiny filtering units called nephrons. Each nephron consists of a ball formed of small blood capillaries, called a glomerulus, and a small tube called a renal tubule. Urea, together with water and other waste substances, forms the urine as it passes through the nephrons and down the renal tubules of the kidney.
Two ureters. These narrow tubes carry urine from the kidneys to the bladder. Muscles in the ureter walls continually tighten and relax forcing urine downward, away from the kidneys.
If urine backs up, or is allowed to stand still, a kidney infection can develop. This means the rest of the kidney can function well. Even when a whole kidney is affected, long-term problems are not likely.
One normal kidney is all we need for good health. Children are often born with a single kidney and no one knows it. People who donate a kidney also do fine. The only issue is that you no longer have a spare kidney. If your remaining kidney is seriously injured for any reason then you would have kidney failure and require dialysis.
Though an ectopic ureter can drain to the sex organs, it does not affect sexual function. In boys, the genital tract on the same side of the ectopic ureter may be abnormal. But if the other side is not affected which is most often the case , then fertility should still be normal. This web site has been optimized for user experience and security, therefore Internet Explorer IE is not a recommended browser.
Thank you. Urology A-Z Ectopic Ureter. What is Ectopic Ureter? See More See Less Incontinence A blocked ureter or incontinence leaking urine can be signs of an ectopic ureter. Boys with ectopic ureters do not often have incontinence, since the ureter drains inside the body. But they may still have signs of swelling or a UTI. Girls with ectopic ureters may leak urine since the ureter drains into or near the vagina.
This problem is clear after toilet training. It is unlike other types of incontinence. Instead, there is a general, all-over moistness rather than events where the bladder looses control. Some girls will be treated with drugs and other things for many years before the right diagnosis is made. Swelling The ureter and part of the kidney can swell when it cannot drain properly. Vesicoureteral Reflux VUR In boys with an ectopic ureter, there may also be a slight flaw in the ureter.
There are some basic tests to see the ureters, kidneys and bladder. See More See Less Ultrasound If the ultrasound before birth shows swelling, then the test is often done again after the child is born.
This test is also used to see if there is reflux in a second ureter linked to the ectopic ureter. 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. The 3 types of surgery to fix this problem are: Nephrectomy Ureteroureterostomy Ureteral reimplantation Each option has pros and cons.
See More See Less Nephrectomy upper pole heminephrectomy In this surgery, the kidney or the part of it drained by the ectopic ureter is removed. Ureteroureterostomy For this surgery, the ectopic ureter is split near the bladder. Ureteral Re-implantation For this surgery, the ectopic ureter is split near the bottom and sewn into the bladder.
This condition is called "megacystis megaureter syndrome. These are wide ureters that aren't caused by blocks or urine backflow. Many of these get better with time.
Your health care provider will check carefully to rule out a block or reflux. This type is caused by a ureter that's blocked and also suffers from reflux.
This is dangerous, as the ureters get bigger and more blocked with time. People with this problem are more likely to get urinary tract infections. These are megaureters that show up as a result of other health problems. Some of these health problems that cause megaureters are:. Health care providers used to find most megaureters when checking a child with a urinary tract infection.
These patients often have fever, back pain, and vomiting. But today, because of the widespread use of checking with ultrasound before birth, most megaureters are discovered as hydronephrosis or a stretched "dilated" urinary tract in the fetus.
Because megaureters can cause severe infection or blocks that lead to kidney damage, this health issue can be serious. Urinary tract stretching may suggest a blockage, but that's not always the case. In some cases, a dilated ureter may not affect the kidney at all. Also, most patients with megaureters found before birth don't get symptoms. It's important to have it checked to make sure it won't affect the way the kidney works and cause problems later.
If your child gets a urinary tract infection , or other symptoms that could be signs of a megaureter, check with your health care provider. Tests used to diagnosis megaureters are:. Ultrasound, also known as sonography, uses sound waves bouncing off organs in the body to make a picture of what's inside.
This painless imaging test is often done to check how the kidney, ureters, and bladder look. Ultrasound is very good at finding widened ureters. In fact, while sonography rarely picks up normal ureters because of their narrowed size, it makes excellent images of dilated ones.
A VCUG is an x-ray test done to look for vesicoureteral reflux. A small tube "catheter" is slid through the urethra into the bladder. A special dye is dripped into the bladder through the tube while x-rays are taken. If there's reflux, the x-ray will show the dye flowing back into the ureter. Diuretic renal kidney scans are used to check for blocks. This test is done by injecting a radioactive liquid into a vein, which then goes to the kidneys.
A computer determines how each kidney is working. The renal scan also tells if a blockage is present. If the kidney's working, a block that could cause a problem isn't likely. MR-U uses magnetic fields to make pictures of what's inside the body.
This test shows the urinary tract even better than ultrasound or diuretic renal scans. MR-U involves injecting dye and getting pictures of the urinary tract using magnetic fields. This test isn't often used for small children because it calls for sedation or general anesthesia. If tests show a block or impaired kidney function, your child may need surgery to fix it. The typical surgery for megaureters involves putting the ureters back into the bladder "ureteral reimplantation" and trimming the widened ureter "ureteral tapering".
Surgery in infants isn't easy and should be done by surgeons skilled at neonatal surgery. Many babies are kept on antibiotics until surgery to help protect them from infections. During the procedure, the surgeon makes a cut in the lower belly.
Depending on the child's anatomy, the surgeon will get to the ureter either through the bladder transvesical or from outside the bladder extravesical.
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