Korean J Urol.  2013 Jul;54(7):482-485.

Bilateral Single Ectopic Ureters Draining Into a Grossly Dilated Vagina in an Adolescent Female

• Mandal SN
• Jagadheesan GP
• Kamal MR
• Mukherjee
• Das RK
• Karmakar D

Abstract

A 16-year-old female presented with dribbling of urine along with voluntary voiding since birth. Renal imaging revealed hydroureteronephrosis on the right side; the uterus and ovary were normal. A radionuclide scan showed a left nonfunctional kidney. On cystovaginoscopy, the urethra was shown to be normal and the urinary bladder was tubular with small capacity and an absent trigone. Although the vagina was capacious, no ureteric orifices were found. Computed tomography corroborated the diagnosis of bilateral, single ectopic ureters draining into a grossly dilated vagina. This case is unique because it is a bilateral single-system ureteral ectopia in a completely differentiated female genital tract that presented late in adolescence. To the best of our knowledge, this is the second such ureteral abnormality reported in the literature so far. The patient underwent ileocystoplasty with right ureteric reimplantation and nephroureterectomy for the left nonfunctional kidney, which histopathology showed to be tuberculosis. The patient is continent with cystometric capacity of more than 300 mL.

Keyword

Abnormalities; Ureter

MeSH Terms

Adolescent
Female
Humans
Kidney
Ovary
Parturition
Replantation
Tuberculosis
Ureter
Urethra
Urinary Bladder
Uterus
Vagina

Figure

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  FIG. 1 (A) Intravenous urogram (IVU) showing right hydroureteronephrosis with contrast filling the capacious vagina. (B) IVU: full apparent urinary bladder (vagina).

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  FIG. 2 (A) Contrast computed tomography (CT) showing grossly dilated vagina (V) with Foley's bulb (F) in situ, anteriorly displaced uterus (U), and rectum (R) posteriorly. (B) Subsequent image to Fig 2A. (C) CT image showing relation of distal vagina (V) with small urinary bladder (UB) and anorectum (AR). UT, uterus.

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  FIG. 3 Intraoperative picture.

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  FIG. 4 (A) Micturating cystourethrogram (MCU) showing reconstructed bladder postileocystoplasty. (B) MCU: postvoid film with adequate emptying.

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