Ureteral triplication is a rare anomaly with about 100 total cases reported in the literature. In this case presentation, we present a case of ureteral triplication in a young female with a history of neurogenic bladder secondary to L5 lipomeningocele who presented with recurrent febrile UTIs and VUR despite antibiotic prophylaxis. Given her high grade reflux, she underwent ureteral reimplantation which ultimately led to resolution of her UTIs and reflux. Later in her clinical course, toilet training unmasked additional bladder dysfunction and she was successfully managed with CIC and anticholinergics. To the best of our knowledge, this is the first case report to describe ureteral triplication, recurrent febrile UTIs and VUR in the setting of a concomitant neurogenic bladder with a successful outcome.
Urology. 2020 Jul 21 [Epub ahead of print]
Tej J Desai, Ankur A Shah, Matthew T Smith, Stephen A Zderic, Chris J Long
Nova Southeastern University - Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, FL, USA. Electronic address: ., Division of Urology, Department of Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA., Department of Urology, SUNY Downstate Medical Center, Brooklyn, NY, USA., Division of Urology, Department of Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA; Division of Urology, Department of Surgery, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.