Case – Utility of magnetic resonance urography in pediatric urinary incontinence: Radiological considerations

A study of children in the U.S. revealed that the incidence of enuresis at age 11 was approximately 7%.1 Primary enuresis can be caused by various diseases, including developmental delay and congenital structural abnormalities. One congenital cause is the ectopic ureter, which is 2–12 times more common in females than males.2 In females, the ureter abnormally inserting distal to the bladder neck causes continuous urinary incontinence. Insertion sites may include, but are not limited to: the urethra, vagina, uterus, or rectum. The evaluation of urogenital conditions (including incontinence) in the pediatric population has traditionally included imaging techniques, such as ultrasonography (US), intravenous urography (IVU), voiding cystourethrography (VCUG), and radionuclide scintigraphy (DMSA).3 The anatomical details provided by these techniques individually are insufficient for the formation of an accurate clinical diagnosis.4 Magnetic resonance urography (MRU) provides more accurate anatomical and functional assessment of the urinary tract.5 In the following case reports, we discuss the delayed diagnosis and treatment of both ectopic kidney and ureter in two young female patients.