Ectopic Ureter Opening in Vagina in a Dual Collecting System: Report of a Case

Abstract

The ectopic ureter is a congenital anomaly characterized by an opening of the ureter outside the bladder trigone. Approximately 80% of cases are associated with a completely dual collecting system, most often involving the ureter draining the upper pole, in accordance with the Weigert-Meyer Law. The majority of cases are diagnosed during childhood, often during continuous urinary leakage or recurrent urinary infections. However, certain cases may remain unknown and be revealed in adulthood. Ultrasound, urography, uroscanner and uro-MRI are currently the examinations which allow the precise diagnosis of these uropathies. Surgical management of an ectopic ureter depends on the functional status of the kidney. Various surgical methods are available including the laparoscopic approach. We report a case of an ectopic ureter draining into the vagina, associated with ureteral duplication, discovered in a 16-year-old girl presenting with urinary incontinence. The investigations and treatment are discussed, as well as hypotheses regarding its embryogenesis, considering data from the literature. Ectopic ureter in a double urinary system is a rare but classic cause of permanent urinary incontinence in young girls, despite preserved voiding. Its diagnosis can be delayed, particularly in resource-limited settings, hence the importance of clinical suspicion in any case of atypical incontinence.