الفهرس 
Materials and methodsOnly 14 pages are availabe for public view
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Abstract
This study was intended to collect more data about
the configurations and positions of the ureteric orifice
and their clinical significance.
This study was conducted on 100 patients. 25 females
and 75 males. They were not selected being referred
to the Urology Department in Benha University Hospital
for urologic investigations. The mean age of the male
patients was 42 + 19 years and the mean age of the female
patients was 33 + 13 years.
Each patient was subjected for full clinical history.
laboratory and radiological investigations. cystoscopic
examinations. and photography of the ureteric
orifice.
In this study. the commonest grade of the ureteric
orifice was grade 0 (56.99 %). followed by grade 2
(32.79 %). then grade 1 (7.53 %) and lastly grade 3
(2.69 %).
Some pathologic abnormalities associated with
the ureteric orifice were recorded in this work e.g.
double ureters. prolapsed mass from the ureteric orifice.
hooded orifice. orifice which change its shape with over131
distension of the urinary bladder.
The distance between
the internal urethral meatus
the submucosal tunnel length
ordinary ureteric catheter.
the ureteric orifice and
as well as the length of
was measured by using the
It was found, from the results of this study,
that the normal trigonal position of the ureteric orifice
”A” position was 72.79 % in males and 86 % in females,
while the ”B” position was 24.26 % in males and 14 %
in females. The ”c” position was 2.94 % in males.
Radiological study for vesicoureteric reflux was
done for every patient and it was evident that minimal
reflux occur in the normal grade ureteric orifice.
Conclusions
(1) The normal shape of the ureteric orifice is slit
or cone shape.
(2) The slit shape is much more common (60 % in females,
and 35.29 % in males) than the cone shape (17 %
in females, and 14.71 % in males).
(3) The horse shoe shape is more common (21 % in females,
and 36.76 % in males) than the stadium shape (2 %
in females, and 9.55 % in males) in our patients.
(4) The golf hole shape is the least shape met with
(2.94 % in males, and not evaluated in our female
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patients) .
(5) The ureteric orifice may show many abnormal shapes,
e.g. hooded orifice, fused lips either partial or
complete, prolapsed masses distorting the shape
of the orifice, orifice without an interureteric
bar, or accessory ureteric orifice.
(6) The configuration of the ureteric orifice may be
changed during overdistension of the urinary bladder.
(1) The normal position of the ureteric orifice (”A”
position) lies at 20 mID from the internal urethral
meatus in females, and at 25 mID in males according
to our measurements.
(8) The ”B” position lies at 21 mID in females, and at
33 mID in males, whereas the ”C” position lies at
40 mIDfrom the internal urethral meatus in males.
(9) The incidence of vesicoureteric reflux in the normal
shapes, without alteration of other factors, is
very minimal. But it increases as the grade of
the ureteric orifice increases.
(10) All the golf hole ureteric orifices are refluxing
because of the very short submucosal tunnel length
of the intravesical part of their ureters.
(11) The submucosal tunnel length of the intravesical
part of the ureter in the ”A” position is about
11 mID, in the ”B” position it is about 1 mID, while
in the ”e” position it is about 2 mID.
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(12) The more lateral the ureteric orifice on the bladder
wall, the shorter its effective submucosal tunnel
length, and the greater the incidence of vesicoureteric
reflux.
(13) Vesicoureteric reflux occurs if the submucosal tunnel
length of the intravesical ureter is 5 mm or less.
(14) The ureteric orifice should be examined while the
urinary bladder is relatively empty and during overdistension
of the bladder. Also, the submucosal
tunnel length should be measured while the bladder
is fUlly distended.
(15) The role of urinary bilharziasis in the development
of the horse shoe ureteric orifice needs further
evaluation.