Bilateral single system ectopic ureters with bilateral urethral insertion and horseshoes kidneys in a female child

A 14-months old female child was diagnosed with bilateral single system ectopic ureters opening into the urethra, with small bladder capacity, horseshoes kidneys, and bilateral hydronephrosis, presenting recurrent febrile UTI accompanied by continuous incontinence and elevated renal function. Early bilateral re-implantation of the ureters (modified Lich-Gregoir) was done in one setting, resulting jn no recurring febrile UTIs and continuous wetting, improving renal function parameter, competent bladder neck, and 10 folds increased in bladder capacity after 1-year follow up. We showed that earlier treatment enables patient to preserve both renal and bladder function without involving complex reconstructive surgery.