Bilateral complete ureteropielocalicial duplicity associated with ectopic ureteral vaginal insertion in childhood: Case report

Abstract

Ureteral duplication associated with ectopic ureteral insertion is a rare congenital anomaly clinically more common in females. Early urinary incontinence is the main symptom of ureteral ectopy in the first childhood of these patients. Contrast computed tomography and magnetic resonance imaging are the most effective imaging methods to rule out or confirm the diagnosis of ectopy associated with ureteral duplication. In cases where significant surgical functions are performed, the reconstructive surgical approach with reimplantation of the ureteral unit is the technique of choice. We present the case of a 6-year-old female patient who was diagnosed with bilateral complete ureteropielocalicial duplicity confirmed by intravenous pyelography. Confirmation of ureteral ectopy only occurred intraoperatively. The surgical correction consisted in reimplantation of the ectopic ureteral unit in the patient's bladder, since preserved renal functions evidenced in renal scintigraphy with DMSA. After performed the procedure, the patient remained asymptomatic and with normal urinary patterns. For the accomplishment of the present study, we used as data source the patient's medical records, useful for the realization of the clinical history from the diagnosis to the definitive surgical treatment that concluded the case. Ureteral duplication associated with ectopic ureteral insertion should be perfectly understood and had with a possible diagnosis for cases of urinary incontinence and recurrent urinary infections. Investigation through detailed physical examination and the use of appropriate imaging tests may help in the early detection of this rare anomaly of the genitourinary tract.