A CASE OF BILATERAL SINGLETON ECTOPIC URETERS WITH UROGENITAL SINUS ? A RARE ENTITY AND ITS INNOVATIVE MANAGEMENT

Purpose: Single-system bilateral ectopic ureters associated with urogenital sinus is a very rare occurrence (only single case has been reported till date in the literature). Methods:An eleven year old girl presented with ‘continence with incontinence' and was found to have bilateral ectopic ureters with vaginalized low confluence urogenital sinus (UGS). The incontinence was deemed to be due to the ectopic ureters as well as short length of urogenital sinus. Results: Decision making was difficult in view of need of both urethral and vaginal reconstruction along with tackling ectopic ureters and incontinence. The urogenital sinus was left as urethra and a peritoneal flap was used to bridge the deficient vagina. A bilateral ureteric reimplantation was done and bladder neck was plicated. The patulous vaginalised urogenital sinus was also narrowed by multiple plicating sutures. This proved to be successful and the patient is continent with a mucosa lined vagina at the end of 1 year follow-up. Conclusion: Bilateral single system ectopic ureter with urogenital sinus can be managed in single stage.