Misplaced opening of one or both ureters in dogs (ureteral ectopia)

  • Occurrence: very rare
  • Location of disease: Abdomen/pelvis
Author: Dr. med. vet. Gisa Löwe | Last modified: 02.08.2026
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When to visit the vet?

Non-urgent see a veterinarian within 2–3 days

?

If the condition worsens / symptoms persist, consult a veterinarian.

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Definition

Ureteral ectopia is a congenital malformation in which one or both ureters in a dog do not correctly enter the bladder, but instead open into the urethra, vagina, or another unusual location, which can lead to urinary incontinence and other health problems.

Das Wichtigste auf einen Blick

Ureteral ectopia in dogs is a congenital malformation in which the ureters do not open into the bladder but into atypical locations such as the urethra or vagina. This anatomical anomaly often leads to uncontrolled urine leakage, as the urine bypasses the bladder and flows directly outward. The causes are mostly genetic, with dog breeds such as Golden Retrievers, Labrador Retrievers, Siberian Huskies, and Miniature Poodles being particularly susceptible. Developmental disorders during pregnancy can also play a role. Diagnosis is made through a thorough medical history, clinical examination, and imaging techniques such as ultrasound or special contrast studies. For treatment, surgical procedures such as ureteroneocystostomy are often required to correctly reposition the ureteral opening into the bladder. Alternatively, endoscopic laser ablation can be performed. The prognosis is generally good if the condition is diagnosed and treated early, although complications such as Scar tissue formation or recurrent urinary tract infections can occur. Prevention focuses on responsible breeding practices and regular veterinary examinations to detect the condition early. Educating breeders and dog owners about the risks and symptoms of ureteral ectopia can help improve the quality of life for affected dogs.

Ursachen

The ureters are tube-like structures that transport urine from the kidneys to the bladder. In a normal anatomical arrangement, the ureters open into the bladder, where urine is stored until it is excreted through the urethra. This correct arrangement is crucial for controlling bladder emptying and preventing incontinence.

In ureteral ectopia, this normal course is disrupted. The ureters do not open into the bladder but instead drain directly into the urethra, vagina, or other atypical locations. This can lead to constant or intermittent urine leakage, as the urine bypasses the bladder and flows directly outward.

The causes of ureteral ectopia are mostly genetic. Certain dog breeds have a predisposition, including Golden Retrievers, Labrador Retrievers, Siberian Huskies, and Miniature Poodles. The genetic predisposition leads to a maldevelopment of the urinary tract during embryonic development.

Other factors that can contribute to the development of ureteral ectopia include developmental disorders during pregnancy, which can be influenced by environmental factors or infections. However, the exact cause is not fully understood in many cases.

Symptoms

Rare symptoms:

The most common symptom of ureteral ectopia is urinary incontinence. Affected dogs often show constant or intermittent urine leakage. This can be particularly noticeable when the dog is relaxed or sleeping. Urine loss can lead to skin irritation in the genital and abdominal areas.

Other symptoms include frequent urinary tract infections, as continuous urine flow increases the risk of bacterial infections. Urinary tract infections can manifest as increased urination, Pain during urination, and blood in the urine.

Some dogs may also show symptoms such as increased drinking or more frequent urination because the bladder fills ineffectively. In female dogs, the misplaced opening of the ureters can lead to inflammation of the vagina, causing additional discharge and discomfort.

Diagnose

The diagnosis of ureteral ectopia begins with a thorough medical history and a clinical examination. The veterinarian will ask about the type and timing of the incontinence as well as other symptoms to get a clearer picture.

Imaging procedures are crucial for diagnosis. An ultrasound examination can provide initial indications of urinary tract anomalies. A special contrast study, urography, can help determine the exact location of the ureteral opening.

A cystoscopy, in which a small camera is inserted into the urethra, allows direct visualization of the internal urinary tract and can help confirm a misplaced opening. In some cases, computed tomography (CT) or magnetic resonance imaging (MRI) may be necessary to obtain a detailed image of the urinary tract.

Therapie

The treatment for ureteral ectopia depends on the severity of the malformation and the specific symptoms. In less severe cases, conservative measures, such as managing urinary tract infections and skin irritations, may be sufficient.

In most cases, however, surgical intervention is necessary to correct the position of the ureteral opening. The most common surgery is ureteroneocystostomy, in which the ureters are reimplanted into the bladder. This surgery has a good success rate but can be technically challenging and requires an experienced surgeon.

An alternative method is endoscopic laser ablation, which uses a laser to correct the misplaced opening. This method is becoming increasingly popular as it is less invasive and offers a shorter recovery time.

Prognose und Nachsorge

The prognosis for dogs with ureteral ectopia is generally good, especially if the condition is detected and treated early. Surgical correction often leads to a significant improvement in symptoms and the dog’s quality of life.

In some cases, however, complications can occur, such as scar tissue formation or recurrent Urinary tract infections. Long-term follow-up care and regular veterinary check-ups are important to monitor treatment success and detect possible complications early.

For dogs that have been successfully operated on, quality of life is generally high, and they can live a normal life. In untreated cases, however, constant incontinence can lead to significant health problems and a reduced quality of life.

Prävention

Since ureteral ectopia has a genetic component, prevention is primarily focused on breeding control. Responsible breeding practices, where affected animals are not used for breeding, can help reduce the spread of the genetic predisposition in the population.

Regular veterinary examinations, especially in breeds with a known predisposition, can help detect the condition early. Early diagnosis and treatment can significantly improve the prognosis and quality of life for affected dogs.

Another preventive measure is educating breeders and dog owners about the signs and risks of ureteral ectopia. This can raise awareness of the condition and ensure that affected dogs receive the necessary medical care in a timely manner.

Ausblick auf aktuelle Forschung

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Ureteral ectopia in dogs is a congenital misplaced opening of the ureter in which urine does not enter the urinary bladder correctly. Typically, urinary incontinence occurs mainly in young female dogs. The most important advance in recent years is that the condition is no longer understood only as a “misplaced ureter”, but as a more complex problem in which the bladder neck, urethra, and sphincter function often also play a role. (merckvetmanual.com, pubmed.ncbi.nlm.nih.gov)

A key area of research is more precise diagnosis. Imaging and endoscopy have advanced significantly; CT and cystoscopy in particular help to better distinguish intramural and extramural forms and to capture concurrent changes in the lower urinary tract more accurately. This is important because the choice of therapy and the chances of success depend heavily on this anatomical classification. (merckvetmanual.com, pubmed.ncbi.nlm.nih.gov)

From a therapeutic perspective, the outlook is particularly interesting. For intramural ureteral ectopia, cystoscopic-guided laser ablation has significantly changed treatment because it is less invasive than open surgery. Research is now primarily investigating which dogs truly become continent afterwards and when additional medication or surgical measures are needed. (pubmed.ncbi.nlm.nih.gov, pubmed.ncbi.nlm.nih.gov)

Overall, research is clearly moving toward better anatomical characterization, individualized therapy, and a more realistic prognosis for continence.

Frequently Asked Questions (FAQs)

1. What is ureteral ectopia?
In ureteral ectopia, one or both ureters do not enter the urinary bladder at the normal location, but at another position in the urinary or reproductive tract, often in the urethra, the vagina, or the vestibule. This can cause urine to drain uncontrollably, leading to incontinence.
2. Which dogs are particularly affected?
Ureteral ectopia is congenital and occurs predominantly in female dogs, about 20 times more often than in males. Predisposed breeds include Golden Retrievers, Labrador Retrievers, Siberian Huskies, Poodles, West Highland White Terriers, Entlebucher Mountain Dogs, and Soft Coated Wheaten Terriers. A hereditary component is assumed.
3. What symptoms are typical?
The key symptom is urinary incontinence from puppyhood, with affected dogs usually leaking urine constantly in drops, often even while sleeping. In addition, Skin inflammation in the genital area, recurrent Urinary tract infections, and a wet coat around the vulva may be noticeable. Some dogs can still urinate normally because one ureter opens normally.
4. How is the diagnosis made?
Medical history and the clinical picture are key. For precise localization, ultrasound, intravenous urography, CT urography, or retrograde vaginourethrography are used. The most accurate method today is vaginoscopy and cystoscopy combined with CT urography, which can show the exact opening site.
5. What forms of ureteral ectopia are there?
A distinction is made between the extramural form, in which the ureter runs completely outside the bladder wall and opens elsewhere, and the intramural form, in which the ureter initially passes through the bladder wall and only opens further distally. The intramural form is more common and can be treated well endoscopically.
6. How is ureteral ectopia treated?
For the intramural form, laser-assisted ablation (LAA) is now the treatment of choice. This involves creating a new opening into the bladder endoscopically, without opening the abdominal cavity. For extramural forms, open surgical reimplantation of the ureter into the bladder (neoureterocystostomy) is necessary.
7. Will the dog be continent after surgery?
Around 50 to 70% of female dogs become continent after correction. The rest retain residual incontinence, often due to concurrent urethral sphincter mechanism incompetence. This can be treated well with medication such as phenylpropanolamine or estrogen preparations, so overall most dogs can live a dry everyday life.
8. What concurrent conditions occur?
Hydroureter and hydronephrosis are common, i.e., dilation of the ureter and renal pelvis due to impaired outflow. Recurrent Urinary tract infections and, in rare cases, reduced kidney function on the affected side can also occur. A careful assessment of the kidneys is important before any surgery.
9. Can male dogs also be affected?
Yes, male dogs are less commonly affected. Because they have a longer urethra and a stronger sphincter, ureteral ectopia is often only noticed later or less clearly. Some males show hardly any symptoms because sphincter function is sufficient. If there are clinical signs, the diagnostic work-up is analogous to that in female dogs.
10. What is the prognosis?
The prognosis is good with timely diagnosis and correct treatment. The majority of dogs achieve a good quality of life with surgical correction and, if necessary, medication support. Regular monitoring of kidney function and the urinary tract is important to detect late effects early.

Literatur

  • Chang, J. S., Berent, A. C., Pavia, P. R., Weisse, C. W., & Bagley, D. H. (2025). Cystoscopic-guided laser ablation of intramural ectopic ureters in male dogs: A retrospective study of 18 cases (2011–2023). Journal of Veterinary Internal Medicine, 39(5), jvim70243. https://doi.org/10.1111/jvim.70243
  • Hooi, K. S., Vachon, C., Martel, D. V., & Dunn, M. (2022). Retrospective evaluation of cystoscopic-guided laser ablation of intramural ectopic ureters in female dogs. Journal of Veterinary Internal Medicine, 36(1), 156–163. https://doi.org/10.1111/jvim.16321
  • Dekerle, B., Maurice, E., Decabron, A., Viateau, V., Maurey, C., & Manassero, M. (2022). Outcomes of 25 female dogs treated for ectopic ureters by open surgery or cystoscopic-guided laser ablation. Veterinary Surgery, 51(4), 568–575. https://doi.org/10.1111/vsu.13807
  • Jacobson, E., Meler, E. N., Delisser, P. J., & Thompson, A. L. (2022). Cystoscopic-guided scissor transection of intramural ectopic ureters as a novel alternate minimally invasive treatment option to laser ablation in female dogs: 8 cases (2011–2020). Journal of the American Veterinary Medical Association, 260(S2), S12–S20. https://doi.org/10.2460/javma.21.03.0153
  • Hoey, C. S. F. K., Friend, E., Meakin, L. B., & Chanoit, G. P. (2021). Long-term outcome of female dogs treated for intramural ectopic ureters with cystoscopic-guided laser ablation. Veterinary Surgery, 50(7), 1449–1462. https://doi.org/10.1111/vsu.13702
  • Berent, A. C., Weisse, C., Mayhew, P. D., Todd, K., Wright, M., & Bagley, D. (2012). Evaluation of cystoscopic-guided laser ablation of intramural ectopic ureters in female dogs. Journal of the American Veterinary Medical Association, 240(6), 716–725. https://doi.org/10.2460/javma.240.6.716
  • Reichler, I. M., Eckrich Specker, C., Hubler, M., Boos, A., Haessig, M., & Arnold, S. (2012). Ectopic ureters in dogs: Clinical features, surgical techniques and outcome. Veterinary Surgery, 41(4), 515–522. https://doi.org/10.1111/j.1532-950X.2012.00952.x
  • Anders, K. J., & McLoughlin, M. A. (2012). Ectopic ureters in male dogs: Review of 16 clinical cases (1999–2007). Journal of the American Animal Hospital Association, 48(6), 390–398. https://doi.org/10.5326/JAAHA-MS-5722