This results in the upper pole ureter
having an opening that is more caudal than the lower pole ureter (Weigert Meyer Rule) .
Dribbling in otherwise normal girls suggests a duplicated collecting system whose upper pole ureter drains ectopically.
The intravenous pyelography (IVP) demonstrated a duplicated collecting system on the left, and the upper pole ureter affluxed into the lower pole collecting system.
In a duplex system this is inevitably the upper pole ureter
, presumably due to its budding from the mesonephric duct later than the lower pole ureteral bud.
Re-approximations of the upper pole ureter
to the lower pole ureter are performed with 6-0 absorbable suture in a running fashion.
Classically, the ureterocele of the upper pole ureter
results in obstruction, while abnormal insertion of the lower pole ureter results in vesicoureteral reflux (Weigert-Meyer rule).
However, if there is reflux into the distal ureter we will remove it down into the "pelvis and remove the distal upper pole ureter
The upper pole ureter
ends outside the grasp of the urethral sphincter, bypassing the bladder, and ending somewhere beneath the sphincter--either on the perineum, in the vagina, alongside the urethra, or up inside the urethra.
After isolation of the renal hilum, the upper pole ureter
was dissected toward the hilum and the atrophic upper pole of the kidney was isolated.