Moshi Brenda, Gidion Daudi, Abeid Muzdalifat, Kaguta Munawar, Chapa James, Majinge Peter
Department of Obstetrics and Gynecology, Aga Khan University Medical College, Dar es Salaam, Tanzania.
Department of Obstetrics and Gynecology, Community Based Rehabilitation in Tanzania, Dar es Salaam, Tanzania.
SAGE Open Med Case Rep. 2024 Oct 7;12:2050313X241287078. doi: 10.1177/2050313X241287078. eCollection 2024.
This case report presents the clinical journey of a 28-year-old nulliparous woman from Dar es Salaam, Tanzania, who sought medical attention due to lifelong urinary leakage since birth, profoundly impacting her emotional well-being and sexual encounters. Clinical examination revealed urinary leakage from the vagina, with unremarkable abdominal and genital findings. Laboratory investigations were normal. Computed tomography intravenous urography revealed a left duplex collecting system with significant hydroureteronephrosis in the left upper moiety, suggestive of an ectopic ureter. Intraoperative exploration confirmed a duplicated left ureter, with the upper moiety implanted into the vaginal canal. Surgical re-implantation of both left ureters into the bladder was successfully performed, correcting the anatomical anomaly. Postoperative follow-up demonstrated marked improvement in urinary symptoms, restoring the patient's confidence and alleviating emotional distress. This case underscores the complexity and rarity of congenital urinary tract anomalies, particularly in resource-constrained settings, and highlights the importance of a stepwise diagnostic and management approach.
本病例报告介绍了一名来自坦桑尼亚达累斯萨拉姆的28岁未育女性的临床历程。该女性自出生以来一直存在尿失禁问题，这对她的情感幸福和性接触产生了深远影响，因此前来就医。临床检查发现阴道漏尿，腹部和生殖器检查未见异常。实验室检查结果正常。计算机断层扫描静脉肾盂造影显示左侧重复肾收集系统，左上部分存在明显的肾盂积水，提示异位输尿管。术中探查证实左侧输尿管重复，上半部分植入阴道管。成功地将左侧两条输尿管重新植入膀胱，纠正了解剖异常。术后随访显示尿路症状明显改善，恢复了患者的信心，减轻了情绪困扰。本病例强调了先天性尿路异常的复杂性和罕见性，特别是在资源有限的环境中，并突出了逐步诊断和管理方法的重要性。
