Bilateral Single System Ureteral Ectopia in a Female Infant: Benefit of Early Intervention

Bilateral Single System Ureteral Ectopia in a Female Infant: Benefit of Early Intervention
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Title:Bilateral Single System Ureteral Ectopia in a Female Infant: Benefit of Early Intervention
Author/Abstract:
Mellmont L. Ocampo, MD and David T. Bolong, MD

Section of Urology, Department of Surgery, University of Santo Tomas Hospital

Bilateral single system ectopic ureter is a rare congenital malformation of the urinary tract. Most of the ureteral ectopia is frequently observed in duplicated collecting systems. They are usually associated with hydronephrosis, renal dysplasia, urinary incontinence and recurrent urinary tract infections. We present a case of a 2 month old female who presented with sepsis neonatorum secondary to urinary tract infection secondary to obstructive uropathy. After control of the infection, the following work-ups were done: voiding cystourethrogram, DTPA renal scan and CT stonogram with cystogram. These tests suggested a bilateral ectopic ureter. At 8 weeks old, she underwent cystoscopy followed by transureteroureterostomy (TUU) left to right, ureteral trimming with right ureteroneocystostomy and double J (DJ) stent insertion. Cystoscopy showed both ureteral orifices located just distal to the bladder neck. Postoperative course was unremarkable and she was discharged on the 6th hospital day. The DJ stent was removed after a month. Repeat ultrasound showed a decrease in the degree of hydronephrosis. Repeat DTPA Renal Scan showed adequate flow with transient stasis. She was clinically asymptomatic and a negative urine culture was documented 6 months postoperatively. This case is presented for its rarity and to show the benefit of early intervention in such situation. 

Key words: bilateral single system, ectopic ureter, transureteroureterostomy, ureteroneocystostomy
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