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Urinary Incontinence in Adulthood in a Course of Ectopic Ureter—Description of Two Clinical Cases with Review of Literature

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Urinary Incontinence in Adulthood in a Course of Ectopic Ureter—Description of Two Clinical Cases with Review of Literature Case Report Urinary Incontinence in Adulthood in a Course of Ectopic Ureter—Description of Two Clinical Cases with Review of Literature Iga Kuliniec 1,International*, Przemysław Journal of Mitura 1, Paweł Płaza 1, Damian Widz 1, Damian Sudoł 1, Michał Godzisz 1, Environmental Research2 2 3 1 Aleksandra Kołodyńskaand Public Health , Marta Monist , Agata Wisz and Krzysztof Bar Case Report 1 Department of Urology and Oncological Urology, Medical University of Lublin, Jaczewskiego 8, Urinary Incontinence20-954 inLublin, Adulthood Poland; [email protected] in a Course (P.M.); [email protected] of Ectopic (P.P.); Ureter—[email protected] of Two Clinical (D.W.); Cases [email protected] with (D.S.); [email protected] (M.G.); Review of [email protected] (K.B.) 2 2nd Department of Gynecology, Medical University of Lublin, Jaczewskiego 8, 20-954 Lublin, Poland; [email protected] (A.K.); [email protected] (M.M.) Iga Kuliniec 1,* , Przemysław Mitura 1 , Paweł Płaza 1, Damian Widz 1 , Damian Sudoł 1, Michał Godzisz 1, 3 Aleksandra Kołody ´nska 2 , Marta Department Monist 2, Agata of Diagnostic Wisz 3 and Imaging, Krzysztof Radiology Bar 1 and Nuclear Medicine, Faculty of Medical Science in Katowice, Medical University of Silesia, Medyków 16, 40-752 Katowice, Poland; [email protected] 1* DepartmentCorrespondence: of Urology and [email protected] Oncological Urology, Medical University of Lublin, Jaczewskiego 8, 20-954 Lublin, Poland; [email protected] (P.M.); [email protected] (P.P.); [email protected] (D.W.); [email protected] (D.S.); [email protected] (M.G.); Abstract:[email protected] Urinary (K.B.)tract pathologies are the most common congenital abnormalities. Duplex colleting 2 2nd Department of Gynecology, Medical University of Lublin, Jaczewskiego 8, 20-954 Lublin, Poland; [email protected] occurs at different (A.K.); stages [email protected] of completion (M.M.) and is usually asymptomatic. Ureteral ectopia is an Citation: Kuliniec, I.; Mitura, P.; 3associatedDepartment of anomaly Diagnostic Imaging, which Radiology may and manifest Nuclear Medicine, as continuous Faculty of Medical incontinence. Science in Katowice, The aim of this article is to Medical University of Silesia, Medyków 16, 40-752 Katowice, Poland; [email protected] Płaza, P.; Widz, D.; Sudoł, D.; *presentCorrespondence: two patients [email protected] with duplex kidney and ureteral ectopia. Both patients presented symptoms Godzisz, M.; Kołodyńska, A.; of continuous urinary incontinence and became symptomatic in the adult life. Abstract: Urinary tract pathologies are the most common congenital abnormalities. Duplex colleting Monist, M.; Wisz, A.; Bar, K. Urinary system occurs at different stages of completion and is usually asymptomatic. Ureteral ectopia is an Incontinence in Adulthood in a Citation: Kuliniec, I.; Mitura, P.; associatedKeywords: anomaly duplex which maykidney; manifest ectopic as continuous ureter incontinence. in adulthood; The aim ureteric of this article enuresis; is to urinary incontinence Course of EPłaza,ctopic P.; Widz,Ureter D.;— Sudoł, D.; present two patients with duplex kidney and ureteral ectopia. Both patients presented symptoms of Godzisz, M.; Kołody´nska,A.; Description of Two Clinical Cases continuous urinary incontinence and became symptomatic in the adult life. Monist, M.; Wisz, A.; Bar, K. Urinary with ReviewIncontinence of Literature. in Adulthood Int. J. in a Keywords: duplex kidney; ectopic ureter in adulthood; ureteric enuresis; urinary incontinence Environ. Res.Course Public of Ectopic Health Ureter— 2021, 18, x. Description of Two Clinical Cases 1. Introduction https://doi.org/10.3390/xxxxxwith Review of Literature. Int. J. Environ. Res. Public Health 2021, 18, 1. IntroductionThe development of the urinary system is a highly complex process. It involves sev- 7084. https://doi.org/10.3390/ Academic Editors: Anna Maria ijerph18137084 eralThe consecutive development of steps the urinary that system need is ato highly be precisely complex process. maintained It involves several in order to achieve physiolog- Paoletti and Marian Klinger consecutiveical development. steps that need The to be development precisely maintained of inthe order urinary to achieve system physiological takes place between 4th and Academic Editors: Anna development. The development of the urinary system takes place between 4th and 10th Maria Paoletti and Marian Klinger gestational10th gestational week [1]. Kidneys week and [1]. ureters Kidneys arise from and the embryologicalureters arise structure from located the inembryological structure lo- Received: 1 May 2021 thecated dorsal in part the of thedorsal embryo part called of intermediate the embryo mesoderm called (Figure interm1)[2].ediate mesoderm (Figure 1) [2]. Accepted: 30Received: June 2021 1 May 2021 Accepted: 30 June 2021 Published: 2 July 2021 Published: 2 July 2021 Publisher’sPublisher’s Note: MDPI Note: MDPI stays stays neu- neutral with regard to jurisdictional claims in tral with publishedregard mapsto andjurisdictional institutional affil- claims in publishediations. maps and institu- tional affiliations. Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article Copyright: © 2021 by the authors. Li- distributed under the terms and FigureFigure 1. Structures1. Structures in the dorsalin the part dorsal of the embryo:part of (1)the intermediate embryo: mesoderm,(1) intermediate (2) paraxial mesoderm, (2) paraxial mes- censee MDPI,conditions Basel, of the CreativeSwitzerland. Commons mesoderm,oderm, (3) notochord, notochord, (4) neural (4) tube,neural (5) yolk tube, sac, (5) (6) lateral yolk plate. sac, (6) lateral plate. This articleAttribution is an open (CC BY)access license article (https:// creativecommons.org/licenses/by/ distributed 4.0/).under the terms and con- ditions of the Creative Commons At- During the process of embryogenesis, the metanephric mesenchyme and ureteric tribution (CC BY) license (http://crea- buds become ureters, renal pelvis, major and minor calyces and collecting tubules. These tivecommons.org/licenses/by/4.0/).Int. J. Environ. Res. Public Health 2021, 18st,ructures 7084. https://doi.org/10.3390/ijerph18137084 migrate cranially towards thehttps://www.mdpi.com/journal/ijerph final localization of the permanent kidney (Fig- ure 2) [3]. Int. J. Environ. Res. Public Health 2021, 18, x. https://doi.org/10.3390/xxxxx www.mdpi.com/journal/ijerph Int. J. Environ. Res.Int. J. Public Environ. Health Res. Public 2021 Health, 18,2021 x FOR, 18, 7084PEER REVIEW 2 of 8 2 of 8 Int. J. Environ. Res. Public Health 2021, 18, x FOR PEERDuring REVIEW the process of embryogenesis, the metanephric mesenchyme and ureteric buds 2 of 8 become ureters, renal pelvis, major and minor calyces and collecting tubules. These struc- tures migrate cranially towards the final localization of the permanent kidney (Figure2)[3] . Figure 2. Physiological development of renal system. (a) Outgrowth of ureteric bud. (b) The metanephric mesenchyme and the ureteric bud migrate cranially toward the final localization of the permanent kidney. Mesonephros atrophies and degenerates. Mesonephric duct migrates caudally and acquires reproductive function [4]. Movement of the structures Figureindicated 2. PhysiologicalwithFigure blue 2. Physiologicalarrows. development (c) developmentDeveloped of renal ofurinary renal system. system. system. (a (a) )Outgrowth Outgrowth of of ureteric ureteric bud. bud. (b) The (b metanephric) The metanephric mesenchyme mesenchyme and the uretericand thebud ureteric migrate bud migratecranially cranially toward toward the the final final localization localization of of the the permanent permanent kidney. kidney. Mesonephros Mesonephros atrophies and atrophies and degenerates.degenerates. Mesonephric Mesonephric duct migratesAn duct abnormal migrates caudally caudally interaction and and acquires acquires between reproductivereproductive the metanephric function function [4]. Movement [4] mesenchyme. Movement of the structures andof the the structures ureteric bud indicated with blue arrows. (c) Developed urinary system. indicated with blue arrows.may (c) Developed lead to congenital urinary system. abnormalities of the kidney and urinary tract (CAKUT). Those constitute Ana wide abnormal range interaction of anatomical between the and metanephric histopathological mesenchyme and pathologies the ureteric budwhich include deformatioAnmay abnormal leadn of to the congenital interaction urinary abnormalities tract between such of theas the kidney metanephric kidney andagenesis, urinary mesenchyme polycystic tract (CAKUT). and kidneys, Those the ureteric horseshoe bud constitute a wide range of anatomical and histopathological pathologies which include may lead to congenital abnormalities of the kidney and urinary tract (CAKUT). Those kidney,deformation duplex collecting of the urinary system tract such and as kidneyduplicated agenesis, ureters polycystic [5]. kidneys,Depending horseshoe on the kind of constituteabnormalkidney, interactiona wide duplex range collecting between of systemanatomical the and metanephric duplicated and histopathological ureters mesenchyme [5]. Depending andpathologies onthe the ureteric kind which of bud include differ- deformatioent formsabnormal ofn CAKUTof interaction the urinary may between be tract presented the metanephricsuch as clinically. kidney mesenchyme agenesis, As a and result the polycystic ureteric
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