Duplicated Collecting System with Ectopic Vaginal Implantation

Area of Science:

• Urology
• Medical Imaging
• Congenital Anomalies

Background:

• Complete ureteral duplication is a congenital anomaly.
• Vaginal implantation of a ureter is rare, especially in adults.
• Urinary incontinence can stem from complex congenital urinary tract abnormalities.

Observation:

• A 54-year-old woman presented with left-sided complete ureteral duplication.
• The upper ureteral moiety drained into the proximal vagina, forming an ureterocele and causing urinary incontinence.
• The lower moiety had a normal ureteral orifice.

Findings:

• MR colpocystodefecography revealed an ureterocele between the bladder and rectum.
• Computed tomography confirmed duplicated ureters with ectopic vaginal implantation of the upper moiety.
• The anomaly involved proximal renal upper pole and distal vaginal implantation.

Implications:

• This case underscores the importance of considering rare congenital anomalies in adult-onset urinary incontinence.
• Advanced imaging techniques like MR and CT are crucial for diagnosing complex ureteral duplications.
• Understanding such anomalies aids in appropriate management and treatment strategies for affected individuals.