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Case Reports in Urology
Volume 2014, Article ID 801063, 5 pages
http://dx.doi.org/10.1155/2014/801063
Case Report

Bilateral Double Ureters with Bladder Neck Diverticulum in a Nigerian Woman Masquerading as an Obstetric Fistula

1Genitourinary Medicine and Urogynaecology Unit, Department of Obstetrics and Gynaecology, Faculty of Clinical Sciences, College of Medicine, University of Ibadan/University College Hospital, Ibadan, Oyo State, Nigeria
2Urology Division, Department of Surgery, Faculty of Clinical Sciences, College of Medicine, University of Ibadan/University College Hospital, Ibadan, Oyo State, Nigeria
3PIUTA Ibadan Centre, University College Hospital, Ibadan, Nigeria

Received 19 August 2014; Accepted 3 December 2014; Published 23 December 2014

Academic Editor: David Duchene

Copyright © 2014 Imran O. Morhason-Bello et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

A 43-year-old woman presented with 20-year history of leakage of urine per vaginam. She had one failed repair attempt. Pelvic examination with dye test showed leakage of clear urine suggestive of ureterovaginal fistula. The preoperative intravenous urogram revealed duplex ureter and cystoscopy showed normally cited ureteric orifices with two other ectopic ureteric openings and bladder diverticula. The definitive surgery performed was ureteric reimplantation (ureteroneocystostomy) of the two distal ureteric to 2 cm superiolateral to the two normal orifices and diverticuloplasty. There was resolution of urinary incontinence after surgery. Three months after surgery, she had urodynamic testing done (cystometry), which showed 220 mLs with no signs of instability or leakage during filling phase but leaked on coughing at maximal bladder capacity. This is to showcase some diagnostic dilemma that could arise with obstetric fistula, which is generally diagnosed by clinical assessment.