Duplex Collecting System with Ectopic Ureters Opening into Vagina: A Case Report

Area of Science:

• Urology
• Pediatric Surgery
• Medical Genetics

Background:

• Urinary incontinence in toilet-trained children warrants investigation for congenital anomalies.
• Ectopic ureteral insertion, particularly with duplex systems, is a rare cause of persistent urinary leakage.
• Recurrent urinary tract infections can be a sign of underlying genitourinary abnormalities.

Observation:

• A 7-year-old girl presented with continuous urinary leakage and recurrent urinary tract infections, despite successful toilet training.
• Imaging revealed a right duplex collecting system with ectopic ureteral insertion into the vagina.
• Associated findings included an aplastic uterus and normal ovaries, suggesting Mayer-Rokitansky-Kuster-Hauser syndrome.

Findings:

• The patient had a complex congenital anomaly involving a duplicated collecting system and a distally inserted ectopic ureter.
• Surgical correction via "common sheath" reimplantation of the ectopic ureters into the bladder was performed.
• The procedure resulted in complete resolution of urinary incontinence and associated symptoms.

Implications:

• Congenital genitourinary abnormalities, such as ectopic ureters, should be strongly considered in the differential diagnosis of urinary incontinence and recurrent UTIs in children.
• This case highlights the importance of thorough diagnostic workup for complex congenital anomalies.
• Successful surgical management can effectively resolve symptoms and improve quality of life.