Embolization of a hypoplastic kidney with a vaginal ectopic ureter in a case of pseudo-incontinence.
Ureteral ectopy into the vagina is a cause of pseudo-incontinence. When the corresponding kidney has a good function, the treatment of choice is the ureter reimplantation, otherwise the alternative is partial or total nephrectomy. To report a case of 18-year-old girl presented with urinary leakage occurring between normal voids that at 11-year-old was found to have, at cistoscopy and vaginoscopy, an left ureteral ectopy into the vagina with a non demonstrable corresponding kidney at conventional intravenous urography, dimercaptosuccinic acid scintigraphy and ultrasonography. Moreover the right kidney was found enlarged but normally located. Her parents refused the explorative laparotomy to localize and to remove the left kidney. We completed the examination with computed tomography that revealed a small hypoplastic and ectopic left kidney located at L4 level. Because the contribution of the hypoplastic kidney to the total renal function was insignificant, we decided to eliminate it. A selective embolization of the left renal artery was performed using polyvinyl alcohol foam. The pseudo-incontinence stopped immediately after The patient was discharged home in II postoperative day and has been free from any leakage for 3 years. Serum creatinine levels and blood pressure returned to their normal values.
Solinas
Andrea
A
Department of Renal Pathology, Unit of Urology, San Michele Hospital, Cagliari, Italy. sol.andrea@tiscali.it
De Giorgi
Franco
F
Frongia
Mauro
M
D000015:Abnormalities, Multiple; D000293:Adolescent; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D007668:Kidney / Q000002:abnormalities*; D014513:Ureter / Q000002:abnormalities*; D014549:Urinary Incontinence / Q000209:etiology* / Q000628:therapy; D014621:Vagina / Q000002:abnormalities*