Bilateral Single-System Ectopic Ureters: A Case Report

Abstract

<title>Abstract</title> Introduction: While 20% of ectopic ureters are bilateral, bilateral single-system ectopic ureters constitute a rare occurrence. It presents as continuous incontinence in females due to the ectopic ureteral openings being located outside the bladder. Case presentation: A 14-year-old female adolescent presented with lifelong urinary incontinence and recurrent urinary tract infections. Physical examination was unremarkable, with no signs of neurologic disorder. Abdominal ultrasound imaging showed bilateral moderate hydroureteronephrosis. The voiding cystourethrogram showed a bladder capacity of 150 ml and a grade 4 vesicoureteral reflux in the left ureter. CT urography revealed a low-capacity bladder with bilateral ectopic ureteral openings and bilateral moderate hydroureteronephrosis. Cystoscopic examination revealed a wide urethra, with both ureteric orifices located within the urethra and an indistinct trigone. Bilateral Politano-Leadbetter ureteric reimplantation was then performed, which resulted in satisfactory continence during follow-up. Conclusion In cases of bilateral single-system ectopic ureters, modern imaging modalities can clearly delineate the anatomy and guide appropriate surgical planning. Ureteral reimplantation can avoid the need for major reconstructive surgery, enabling patients to achieve normal bladder function and satisfactory continence.