National Board of Examinations Journal of Medical Sciences (Jun 2024)

A Documented Rare Case of a Duplicated Renal Collecting System with Ectopic Opening into the Vagina Managed with Robotic Assisted Heminephrectomy of the Non- Functioning Upper Moiety

  • Varun Agarwal,
  • Ojas Vijayanand Potdar

DOI
https://doi.org/10.61770/NBEJMS.2024.v02.i06.014
Journal volume & issue
Vol. Volume 2, no. Issue 6
pp. 634 – 644

Abstract

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Background: The definition of ectopic ureter is an abnormal opening of the ureter (single or duplex) that does not open in the trigonal region of the bladder. In 80% of these cases, ectopic ureter is associated with complete duplication. The upper moiety of a duplex kidney is usually the origin of a ectopic ureter in most of the cases. The opening of the ectopic ureteric in females can be anywhere from bladder neck to perineum with urethra, vagina, and vestibule. Duplex kidney, also known as duplex collecting system, is a common congenital urinary system anomaly with a morbidity of about 0.8–1%. We present a unique case of a completed duplicated system with ectopic ureter opening into the uterus leading to a non-functional associated upper renal moiety of the affected side which was managed by robotic assisted segmental nephrectomy. Case presentation: We present a case of 52-year- old lady who presented to urology outpatient department with complaints of sticky white perineal discharge through vaginum associated with left sided intermittent colicky flank pain who was diagnosed to have complete duplex left moiety with ectopic insertion of the upper moiety ureter into the vagina associated with non-functioning left upper renal moiety. She was managed by robotic assisted Left sided heminephrectomy with excision of left ectopic ureter. Conclusion: Our case report thus highlights the importance of adequate evaluation of a patient to determine the anatomy and the function of the kidney to decide for the definitive management of these patients with ectopic ureter and duplex kidneys.

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