The duplicated renal collecting system with ectopic ureter draining in the proximal third of the vagina is a rare congenital anomaly that causes incontinence and urinary tract infections. It frequently occurs in association with a poorly functioning upper pole segment. The standard treatment is the upper pole heminephrectomy with ureterectomy.
Our objective is to describe an infrequent cause of urinary incontinence like an ectopic ureter draining into the vagina and its minimally invasive treatment.

A 23-year-old G0 female was referred to our hospital with complaints of continuous urine leakage not related to efforts or urgency for the past four years. Treated in another center with a transobturator sling with unfavorable results. She used four daily-pads and had urinary frequency every 1 hour. She never had urinary tract infections.
Cystoscopic evaluation of the lower urinary tract and urodynamic evaluation of bladder and urethral function were normal. Also had gynecological exam without particularities. CT scan revealed a dysplastic duplex kidney located at right upper-pole unit, drained by a dilated ureter extending to the vagina. Upper pole heminephrectomy with ureterectomy was performed. Exploration of the right kidney demonstrated a dysplastic upper-pole segment with a draining dilated ureter.

Mean surgical time was 80 minutes. Postoperative hospital stay was 2 days. Pathological anatomy informed stromal fibrosis and chronic inflammation. Following surgical intervention, the patient reported immediate and complete resolution of urinary incontinence and significant improvement of her quality of life.

Ectopic ureter should be considered in case of persistent urinary leakage, specially in young women. Laparoscopic upper-pole heminephrectomy with ureterectomy for an ectopic ureter is safe and reproducible and offers benefits of laparoscopic surgery.

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