Remnant ureter abscess linked to obstructed hemivagina and ipsilateral renal anomaly syndrome

Patients with obstructed hemivagina and ipsilateral renal anomaly (OHVIRA) syndrome sometimes present with distinct symptoms related to coexisting urogenital abnormalities. We present a case of refractory abscess formation in a blind-ended remnant ureter associated with ipsilateral renal agenesis. A 15-year-old patient with OHVIRA syndrome, who had a blind-ended remnant ureter, underwent obstructed hemivagina opening 18 months after menarche due to heavy genital bleeding and abdominal pain after the end of menstruation. Four years later, the patient presented with recurring fever and abdominal pain due to a refractory abscess in the ureter. Although the continuity between the ureter and the previously opened hemivagina was not identified, the same bacteria were detected in the abscess and vaginal discharge, indicating that an ascending bacterial infection of the vagina may cause refractory abscess formation in a blind-ended remnant ureter. Open ureterectomy with partial bladder resection was needed to resolve the symptoms.