Prakash Jai, Singh Bhupendra Pal, Sankhwar Satyanarayan, Goel Apul
Department of Urology, King George Medical University, Lucknow, Uttar Pradesh, India.
BMJ Case Rep. 2013 Jun 3;2013:bcr2013009563. doi: 10.1136/bcr-2013-009563.
Association of single system ectopic ureter with normal functioning bilateral kidney and absence of congenital anomalies is very rarely reported in the literature. We are reporting for the first time a case of this type of anomaly in which uretral ectopia was draining into a Gartner's cyst and was managed by laparoscopy. A 16 year girl presented with normal voiding with continuous dribbling since birth. Voiding cystourethrogram, intravenous urogram, cystovaginoscopy and retrograde contrast study confirmed the diagnosis. Ultrasound of the whole abdomen and physical examination ruled out any associated congenital anomalies. Transperitoneal laparoscopic ureteric reimplantation was performed and distal stump was ligated. On follow-up at 3 months she was completely dry; her vaginoscopy showed disappearance of cystic bulge and her voiding cystourethrogram showed normal study without any reflux. When single system ectopic ureter opens into small-to-moderate size wide opened mouth vaginal Gartner's cyst, laparoscopic ureteric reimplantation and ligation of distal stump is an appropriate procedure.
单系统异位输尿管合并双侧肾功能正常且无先天性异常的情况在文献中鲜有报道。我们首次报告了一例此类异常病例，该病例中输尿管异位开口于加特纳囊肿，并通过腹腔镜进行了治疗。一名16岁女孩自出生以来排尿正常，但伴有持续滴尿。排尿性膀胱尿道造影、静脉肾盂造影、膀胱阴道镜检查和逆行造影研究证实了诊断。全腹超声检查和体格检查排除了任何相关的先天性异常。进行了经腹腹腔镜输尿管再植术，并结扎了远端残端。在3个月的随访中，她完全不再滴尿；阴道镜检查显示囊性隆起消失，排尿性膀胱尿道造影显示检查结果正常，无任何反流。当单系统异位输尿管开口于小至中等大小、开口较宽的阴道加特纳囊肿时，腹腔镜输尿管再植术和远端残端结扎是一种合适的手术方法。
