[Ectopic ureter ending in the seminal vesicle in adults. Apropos of a case and review of the literature].

The authors report a 38 years old patient in whom an intravenous pyelogram was performed for moderate arterial hypertension. This showed a large filling defect in the right lower part of the bladder without renal function on that side. Endoscopic separation of the jet coming from the right half of the trigone showed a liquid containing numerous spermatozoa. A cystogram opacified by reflux a cavity in the genital system via this, the right ureter. With the diagnosis of ectopic ureter ending in the genital system, a nephro-ureterectomy demonstrated the attachment of the ureter into a pouch which communicated with the bladder and the seminal vesicle. A view of the normal embryology insists on the fact that contrary to the classic view, the pronephros disappears entirely and that the metanephros is at the origin of the Woffian canal which opens on the posterior wall of the urogenital sinus at the 28th day when the ureter springs from a ureteral bud. Since 1960 this would be the 34th case in the literature, seminal ectopia (24%) coming after ectopia in the prostatic urethra (54%). Epididymitis is a frequent presenting symptom (44%). The workup shows: absence of renal function (100%), raising of the ipsilateral trigone by a cystic swelling (76%), absence of the meatus on that side on endoscopy, presence of an ipsilateral mass above the prostate on rectal examination (30%). The diagnosis is confirmed by vasography where the ureter is opacified by the seminal vesicle or by systography after endoscopic incision of the mass. Excision of the seminal vesicle was done in conjunction with total nephroureterectomy in 17% of cases.