Ectopic ureter in an adolescent female with vaginal discharge: a case report

Avery M. Whitis, University of Iowa Carver College of Medicine, Iowa City, Iowa
Colleen K. Stockdale, University of Iowa Hospitals and Clinics, Department of Obstetrics and Gynecology, Iowa City, Iowa


Background: An ectopic ureter inserts at a site other than the bladder neck, including urethra, vagina, and vestibule in women. These are typically diagnosed in childhood with the onset of continuous urinary incontinence after toilet training. However, they can be difficult to diagnose and rarely present in adults as urinary incontinence refractory to treatment.

Case: A 17-year-old female presented with a five-year history of profuse, watery vaginal discharge and recurrent urinary tract infections, in the setting of normal voiding patterns. Discharge was initially categorized as physiologic. After months without improvement, CT urogram revealed a duplex left sided ureteral system that drained the upper moiety of the left kidney and inserted into the vagina. She was treated with surgical ureteral reimplantation.

Conclusion: Ectopic ureters can commonly implant in the vagina and can rarely present with profuse, watery vaginal discharge in the setting of normal voiding patterns. Physicians must have a high index of suspicion for ectopic ureters in the patient with vaginal discharge refractory to treatment.