Korean J Urol.  2007 Nov;48(11):1182-1185. 10.4111/kju.2007.48.11.1182.

Duplicated Ureter with an Ectopic Ureteral Orifice in a Middle Aged Female Who Complained of Vaginal Discharge

• Jang WK
• Lee JH
• Lee YK
• Hong YK

• KMID: 1997099
• DOI: http://doi.org/10.4111/kju.2007.48.11.1182

Abstract

Duplication is the most common type of congenital anomaly of the ureter. It occurs more frequently in females and it is often accompanied by an ectopic orifice. Ectopic ureter is usually derived from the upper pole of the ipsilateral kidney and its orifice is attached medial & inferior from the normal opening according to Weigert-Meyer's law. Thus, sometimes the ectopic ureteral opening is made at a distal part of the external sphincter or even out of the urinary system. These conditions may result in urinary incontinence in female patients, so they can be treated early at the mean age of 5 and it's not common that ectopic ureter accompanying complete duplication of the ureter is presented in adults. We report here on a case of ectopic ureter accompanying complete duplication of the ureter in a 44 year old female who presented with leukorrhea.

Keyword

Ureter; Urogenital abnormality

MeSH Terms

Adult
Female*
Humans
Jurisprudence
Kidney
Leukorrhea
Middle Aged*
Ureter*
Urinary Incontinence
Urogenital Abnormalities
Vaginal Discharge*

Figure

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  Fig. 1 Markedly dilated visible portion of the left distal ureter with an enhancing wall, distally extending to the level of the vagina near the urethra.

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  Fig. 2 The upper pole of the kidney with invisible renal parenchyma, due to severe hydronephrosis, is draining into an elongated tubular structure that was noted on the previous pelvic CT scan. The mid & lower pole of the kidney have normal renal parenchyme & ureter draining to the bladder.

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  Fig. 3 Retrograde pyelography (RGP) of the lower ureter.

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  Fig. 4 (A) Residual cystic structure at the left kidney upper medial portion, (B) residual cystic structure at the left kidney upper medial portion.

Reference

1. Schlussel RN, Retik AB. Walsh PC, Retik AB, Vaughan ED, Wein AJ, editors. Ectopic ureter, ureterocele, and other anomalies of the ureter. Campbell's urology. 2001. 8th ed. Philadelphia: Saunders;2008–2016.

2. Borer JG, Bauer SB, Peters CA, Diamond DA, Decter RM, Shapiro E. A single-system ectopic ureter draining an ectopic dysplastic kidney: delayed diagnosis in the young female with continuous urinary incontinence. Br J Urol. 1998. 81:474–478.

3. Kang SH, Kang SG, Lee CH, Shin JH, Yoon DK, Cho JH. Ectopic ureter associated with ipsilateral renal dysgenesis. Korean J Urol. 2004. 45:84–87.

4. Kim HT, Yoo ES, Chung SK. Management of upper moiety in complete duplex system. Korean J Urol. 2005. 46:7–13.

5. See WA, Mayo M. Ectopic ureter: a rare cause of purulent vaginal discharge. Obstet Gynecol. 1991. 78:552–555.

6. Koyanagi T, Hisajima S, Sakashita S, Goto T, Tsuji I. Ureteral ectopia in vestibule without urinary incontinence. Urology. 1980. 16:508–510.

7. Fujii A, Yasuno H, Arakawa S, Kamidono S, Umezu K. Ectopic ureter without urinary incontinence despite ureteric orifice in the vestibulum: report of one case. Hinyokika Kiyo. 1985. 31:665–669.

8. Yoshioka M, Okamoto E, Nojima M, Ihara H, Shima H, Ikoma F, et al. Ectopic ureter opening to vestibule without urinary incontinence: a case report. Hinyokika Kiyo. 1992. 38:945–948.

9. Chung YE, Kim HS, Oh KY, Park YI. One case of duplicated ureter associated with ectopic ureteral orifice. Korean J Urol. 1979. 20:647–651.

10. Androulakakis PA, Stephanidis A, Antoniou A, Christophoridis C. Outcome of the distal ureteric stump after (hemi) nephrectomy and subtotal ureterectomy for reflux or obstruction. BJU Int. 2001. 88:586–589.