Gebreziher Yirgalem Teklebirhan, Zeru Enderta Abrha, Negash Hadush Tesfay, Gebre Berihu Tadishu
Department of Surgery, Ayder Comprensive Specialized Hospital, Mekelle University, Mek'ele, Ethiopia.
Department of Radiology, Ayder Comprensive Specialized Hospital, Mekelle University, Mek'ele, Ethiopia.
J Med Case Rep. 2025 Mar 18;19(1):121. doi: 10.1186/s13256-025-05120-6.
While 20% of ectopic ureters are bilateral, bilateral single-system ectopic ureters constitute a rare occurrence. They present as continuous incontinence in females owing to the ectopic ureteral openings being located outside the bladder. Managing bilateral single-system ectopic ureters can be challenging owing to the reduced bladder capacity and incompetent bladder neck. Major reconstructive procedures, such as bladder augmentation and bladder neck reconstruction, may be necessary in addition to ureteral reimplantation to address these issues.
A 14-year-old Ethiopian 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. Computed tomography 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.
Bilateral single-system ectopic ureters represent an infrequent clinical entity. In such cases, modern imaging techniques can guide surgical planning, and in selected patients, ureteral reimplantation may allow normal bladder function and satisfactory continence without major reconstructive surgery.
虽然20%的异位输尿管是双侧的，但双侧单系统异位输尿管却很少见。由于异位输尿管开口位于膀胱外，女性患者会出现持续性尿失禁。由于膀胱容量减小和膀胱颈功能不全，处理双侧单系统异位输尿管具有挑战性。除输尿管再植术外，可能还需要进行诸如膀胱扩大术和膀胱颈重建术等主要重建手术来解决这些问题。
一名14岁的埃塞俄比亚女性青少年因终生尿失禁和反复尿路感染前来就诊。体格检查无异常，未发现神经系统疾病迹象。腹部超声成像显示双侧中度肾盂输尿管积水。排尿性膀胱尿道造影显示膀胱容量为150毫升，左侧输尿管有4级膀胱输尿管反流。计算机断层扫描尿路造影显示膀胱容量小，双侧输尿管开口异位，双侧中度肾盂输尿管积水。膀胱镜检查显示尿道宽阔，双侧输尿管口均位于尿道内，三角区不清晰。随后进行了双侧波利塔诺-利德贝特输尿管再植术，随访期间尿失禁情况令人满意。
双侧单系统异位输尿管是一种罕见的临床情况。在这种情况下，现代成像技术可指导手术规划，对于部分患者，输尿管再植术可使膀胱功能正常，尿失禁情况令人满意，而无需进行主要重建手术。
