Department of Surgery, Kanti Children's Hospital, Maharajgunj, Kathmandu, Nepal.
JNMA J Nepal Med Assoc. 2022 Feb 15;60(246):204-206. doi: 10.31729/jnma.6570.
Continuous urinary leakage, along with normal deliberate voiding, must suggest diagnosis of ectopic ureter, specifically in girls. Combination of a duplicated collecting system with distal, infra-sphincteric, vaginal insertion of ureter is an uncommon congenital anomaly and rare cause of urinary incontinence. We present a case report of a 7-year-old girl who presented to the urology department with urinary incontinence despite successful toilet training and history of recurrent urinary tract infections. Right duplex collecting system was seen on ultrasound. Magnetic resonance urography revealed a near complete right duplex collecting system with ectopic insertion of ureter into vagina, and aplastic uterus with bilateral normal ovaries suggestive of Mayer-Rokitansky-Kuster-Hauser syndrome. Surgical treatment consisted of "common sheath" reimplantation of ectopic ureters into bladder, with complete resolution of symptoms. This case suggests to us that congenital abnormalities of the genitourinary tract should be considered in case of urinary incontinence and recurrent urinary tract infections.
持续的尿失禁，伴随着正常的刻意排空，必须提示异位输尿管的诊断，特别是在女孩中。具有远端、肛门下、阴道插入的输尿管的双重收集系统是一种罕见的先天性异常，也是尿失禁的罕见原因。我们报告了一例 7 岁女孩的病例，她在接受泌尿科治疗时出现尿失禁，尽管已经成功进行了如厕训练，并且有反复尿路感染的病史。超声显示右侧双重收集系统。磁共振尿路成像显示右侧近乎完全的双重收集系统，输尿管异位插入阴道，以及无子宫伴双侧正常卵巢，提示 Mayer-Rokitansky-Kuster-Hauser 综合征。手术治疗包括将异位输尿管“共同鞘”再植入膀胱，症状完全缓解。这个病例让我们意识到，在出现尿失禁和反复尿路感染的情况下，应考虑泌尿生殖系统的先天性异常。
