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MMSinai Grace Hospital

• Brent Zamzow DO

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Intra-op Consult

• 54 female No urine output
• Open cholecystectomy
• Normal pre-op renal function
• Intra-op fluids
• 1900cc blood loss
• 4L LR
• 2u PRBC, 2u FFP, 10 platelets
• Urine output 0
• Foley placed by surgery resident pre-op
  irrigated

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Course of events

• Foley removed replaced
• Irrigated easily
• Sent to PACU
• Bladder scan in PACU 800cc
• Flexible cysto in PACU

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Results

• Anatomy
• Duplicated Left Ureter
• Ectopic ureter inserting into urethra
• Poorly functioning left upper pole kidney
• Flexible cysto
• Scoped left upper pole ureter
• Wire/Council catheter placed into bladder 800cc
• What happened?
• Foley placed into ectopic ureter intraop

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Ectopic Ureter

• Terminates bladder neck or distally
• More common in females (2.91)
• gt80 in females associated w/ duplicated system
• Female
• Urethra 35
• Vestibule 34
• Vagina 25
• Cervix or uterus 5
• Other lt1

• Male
• Posterior urethra 60
• Seminal vesicle 33
• Prostatic utricle 10
• Ejaculatory duct 5
• Vas deferens 5

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• END