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[Ectopic ureter opening in the vestibulum without urinary incontinence: a case report]
S Matsumoto1, K Shimada, S Hosokawa
1Division of Urology, Osaka Medical Center.
Hinyokika Kiyo. Acta Urologica Japonica
|December 1, 1996
Summary
A rare case of ectopic ureter in a young female, presenting with genital pain and hematuria, did not cause urinary incontinence. This finding challenges typical expectations for ectopic ureters, suggesting unique anatomical factors may preserve continence.
Area of Science:
- Urology
- Pediatric Urology
- Anatomy
Background:
- Ectopic ureters, particularly those opening into the vestibule, are often associated with urinary incontinence in children.
- Complete ureteral duplication with an ectopic orifice can lead to complex clinical presentations.
Observation:
- A 2-year-and-9-month-old female presented with external genitalia pain, pollakisuria, and hematuria.
- Diagnostic imaging revealed a complete double system of the left upper urinary tract with the upper moiety's ureter opening into the vestibule.
- Despite the vestibular opening, the patient exhibited no urinary incontinence after establishing voiding habits.
Findings:
- Radioisotope (RI) scintigraphy confirmed functional upper moiety of the left kidney.
- A surgical intervention of left ureterocystoneostomy with a psoas hitch procedure was performed.
- The case is the tenth reported instance of such a condition in Japan.
Implications:
- The absence of incontinence suggests that the specific anatomical course of the ectopic ureter, potentially bypassing urethral sphincter musculature, may preserve continence.
- This case highlights the variability in clinical presentation of ectopic ureters and the importance of detailed anatomical assessment.
- Further research into the continence mechanisms in ectopic ureters is warranted.