Prolapsed single system ureterocele in a female adult: case report

A 36 year old female teacher, presented with a bleeding mass in the introitus, difficult micturition, and dysuria of four months duration. She was a para 3+0, all spontaneous vertex deliveries, her last delivery was in 2001. She was first seen at a private mission hospital in March 2006 where an attempt to excise the mass was made but was abandoned due to bleeding. She was later discharged and re-admitted to a second mission hospital. On examination the mass was firm, round in shape about 2.5 cm in diameter, dark red in colour with a catgut stitch and areas of necrosis. The patient was investigated and a diagnosis of a prolapsing ureterocele was made and a transvesical excision was undertaken. A repeat IVP done six months later revealed no hydronephrosis and urea and electrolyte (U/E) were normal. This case is reported to highlight one of the differential diagnoses that should be considered when evaluating masses at the introitus in a female patient. The presentation, diagnosis, and management protocols are discussed. Thus far no local case reports have been established.