Undiagnosed ureterovaginal fistula in congenital duplex kidney with ectopic ureteric insertion to urethra; something to look for?
Keywords:Ectopic ureter; urinary incontinence; female; urinary tract fistula
Continuous urinary incontinence in young female with normal voiding pattern should prompt proper assessment for ectopic ureter.
We report a young female who presents with continuous urinary incontinence and malodour urine. She was frequently treated as recurrent urinary tract infection which subsequently referred to urology unit. Initial imaging revealed right duplex kidney with ectopic ureter, which she had undergone right heminephrectomy, however her symptoms does not improve significantly. Further evaluation revealed uretero â€“ urethral fistula and uretero â€“ vaginal fistula. She had then undergone urethroureteral and ureterovaginal fistula repair, which resolved her distressing urinary incontinence issue.
J.G. Borer et al. A Single â€“ system ectopic ureter draining an ectopic dysplastic kidney: delayed diagnosis in the young female with continuous urinary incontinence. British Journal of Urology. 1998; 81, 474 â€“ 78
Ellerker AG. The extravesical ectopic ureter. Br J Surg. 1958; 45, 344 â€“ 53
Borer JG, Corgan FJ, Krantz R, Gordon DH, Maiman M, Glassberg K. Unilateral single vaginal ectopic ureter with ipsilateral hypoplastic pelvic kidney and bicornuate uterus. J Urol 1993; 149: 1124â€“7
Gharagozloo AM, Lebowitz RL. Detection of a poorly functioning malpositioned kidney with single ectopic ureter in girls with urinary dribbling: imaging evaluation in five patients. Am J Roentgen 1995; 164: 957â€“61.
Schlussel RN, Retik AB. Anomalies of the ureter. In Walsh PC, Retik AB, Vaughan ED Jr, Wein AJ, eds, Campbellâ€™s Urology, 7th edn, Vol. 2. Philadelphia: WB Saunders, 1997: 1820â€“9
Liu KKW, Yeung CK, Lee KH, Ku KW. Ectopic ureter as a cause of wetting: the role of laparoscopy in its management. Aust NZ J Surg 1996; 66: 325â€“6
Suzuki K, Ihara H, Kurita Y et al. Laparoscopic nephrectomy for atrophic kidney associated with ectopic ureter in a child. Eur Urol 1993; 23: 463â€“5
Moores D, Cohen R, Hayden L. Laparoscopic excision of pelvic kidney with single vaginal ectopic ureter. J Pediatr Surg 1997; 32: 634â€“5