The unusual presenting symptoms, clinical management and roentgenologic diagnosis of an instance of ectopic urethral ureter in four adult female patients are delineated in terms of the embryologic preface, the dysplastic upper renal segment and the lower urinary tract findings associated with urinary tract infections. Surgical management consists of heminephrectomy and partial ureterectomy. Total ureterectomy is necessary if reflux exists in the ectopic ureter, with a vesicovaginal or ureterovaginal fistula being a possible complication in the latter operation. Ureteroneocystostomy may be used in the treatment of an ectopic ureter if the corresponding renal segment is functioning adequately.
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