Anomalias congênitas do trato urinário superior: novas imagens das mesmas doenças

Urinary Incontinence Due to Complete Ureteral Duplication With an Ectopic Vulvar Ureteral Orifice: A Case Report

Ureteral duplication is one of the most common congenital malformations of the urinary tract and may be complete or incomplete. One of the complications of complete ureteral duplication is an ectopic ureter orifice, which, depending on the opening site, may cause urinary incontinence in females, a condition with potentially serious repercussions on the woman's quality of life. Thus, the present study aims to report the case of a 24-year-old female patient with a complaint of urinary incontinence since childhood. After a physical examination and imaging tests, she was diagnosed with complete ureteral duplication on the left side, associated with sequelar parenchymal atrophy of the upper pole of the left kidney, and ectopic vulvar ureter. The patient underwent a videolaparoscopic left upper polar nephrectomy, and her symptoms improved after surgery. This report intends to add to already available data in the literature, highlighting the relevance of anamnesis and physical examination in reaching a diagnosis and implementing appropriate treatment, thus improving the quality of life of individuals with this condition. In addition, these data should be useful both for the medical community and for future studies on this malformation.

Right supernumerary kidney with urothelial carcinoma: A case report

RATIONALE

A supernumerary kidney is an extremely rare renal anomaly. Currently, <100 cases are reported in the literature. There are only 2 right unilateral supernumerary kidneys reported in the literature thus far, but no confirmed cases of urothelial carcinoma in supernumerary kidneys. We report a case of a right supernumerary with urothelial carcinoma, which is, to the best of our knowledge, reported for the first time.

PATIENT CONCERNS

A 73-year-old female patient presented with intermittent, painless, whole course and gross hematuria for about 3 months. Her physical and laboratory examinations did not reveal any significant findings except positive occult blood in routine urine examination. Contrast-enhanced spiral computed tomography revealed a dysplastic supernumerary kidney under the normal right kidney.

DIAGNOSES

The ureteroscopy showed that the ureter was Y-shaped in the middle part. The medial ureter led to a normal kidney. The lateral ureter was just 2 cm and led to a small cavity in which there was a mass whose biopsy showed urothelial carcinoma. The patient was subsequently diagnosed with a right supernumerary kidney with urothelial carcinoma.

INTERVENTION

Nephroureterectomy, including the right normal and supernumerary kidneys, and partial cystectomy by laparoscopy were performed after the ureteroscopy. The patient then received 6 cycles of gemcitabine and cisplatin regimen chemotherapy and regular intravesical epirubicin chemotherapy.

OUTCOMES

No recurrence or metastasis was found on follow-up computed tomography performed 13 months postoperatively.

LESSONS

A supernumerary kidney is an extremely rare renal anomaly. Malignancy can occur in supernumerary kidneys.