Instances are recorded where dilated ureters appear to have served the purpose of subsidiary bladders. Here it is probable that the obstructions were not progressive, and though urine might have been retained in these dilated tubes the flow through them was sufficiently free to prevent any decomposition of the excretion taking place. Cases of this kind with observations have been published by Hutinel" and others.
Some malformations and displacements of the ureters which have required surgical interference may be noticed here. Dr. F. H. Davenport" records a case of incontinence of urine due to malposi tion of a ureter. The patient was a female, aged twenty-nine, the mother of three children, who had suffered from incontinence of urine all her life. This was found to be due to "a malformation of the ureter, which, instead of turning into the bladder at its normal place, was continued along the septum between the bladder and vagina and emptied by a special opening near the meatus." Dr. Baker " appears also to have described and subsequently operated upon a similar case. Dr. Davenport states "the indication in his
case was, if possible, to dissect up the ureter from its bed in the ante rior vaginal wall to a point corresponding to where it could normally enter the bladder, make an opening into the bladder, turn the ureter in and fasten it there, and then close the fistula." This appears to have been satisfactorily accomplished.
Mr. Davies-Colley " furnishes the particulars of a case he treated for protrusion of the orifice of a ureter through the meatus urinarius iu a female child. Examination with the finger and a probe showed that the protrusion came from the left side of the bladder. The mass was ligatured in two halves so as not to obstruct the ureter, and was then cut off. For a few days the patient seemed relieved, but gradu ally sank. The protrusion was confined to the mucous membrane surrounding the opening of the ureter and did not involve any other portion of the tube. Caine " reports a very similar case.