Bilateral Ectopic Ureters with Vaginal Insertion in a Duplex Collecting System: A Case Report of a Rare Case

Abstract

The usual opening of the ureters is in the trigone of the bladder. However, it may open in an infrasphincteric location causing urinary incontinence with normal voiding. This is more commonly associated with a duplex collecting system in females, albeit, a bilateral occurrence of ectopic ureters with drainage into the vagina is rare. We report a rare case of bilateral occurrence of a duplex collecting system with drainage into the vagina. She was a 3-year-old girl with a complaint of continuous dripping of urine despite normal voiding. There was no history of fever, difficulty with micturition, fecal soiling, back swelling, or pelvic surgery in the past. She had normal female external genitalia with two openings in the vestibule. A computerized tomography urography showed a bilateral duplex collecting system with prompt and symmetric excretion of contrast, and dilated ureters of the upper renal moiety draining into the vagina bilaterally. We reimplanted the ectopic ureters with a resolution of urinary incontinence.

Keywords

• case report; duplex system; ectopic ureters; urinary incontinence; vaginal insertion