Continent Cutaneous Urinary Diversion With Augmentation Cystoplasty and Bladder Neck Closure for a Single-System Ectopic Ureter in an Adolescent Girl: A Report of a Rare Case.

A single-system ectopic ureter draining a solitary functioning kidney is a rare cause of lifelong continuous urinary incontinence in girls and may be accompanied by a hypoplastic, poorly compliant bladder and a deficient bladder neck. This anatomy renders urethral continence unattainable and places the only kidney at risk, demanding complex lower urinary tract reconstruction. A 16-year-old girl presented with continuous urinary incontinence since birth and inability to void a stream. Imaging showed an absent right kidney and a solitary, grossly hydronephrotic left kidney with cortical thinning, drained by a dilated, tortuous single ectopic ureter opening near the bladder neck. Cystoscopy revealed a low-capacity bladder (~40 mL) with an incompetent bladder neck. Serum creatinine (2.5 mg/dL) improved to 1.4 mg/dL after a left percutaneous nephrostomy. She underwent single-stage reconstruction comprising ileal augmentation cystoplasty, bladder neck closure, left ureteric reimplantation, and an appendico-caecal Mitrofanoff continent catheterisable channel brought out as a right-lower-quadrant V-flap stoma. The postoperative course was uneventful, and clean intermittent catheterisation via the stoma was established by the sixth postoperative week. Continent cutaneous urinary diversion with augmentation cystoplasty provides a durable solution that restores continence, creates a low-pressure reservoir, and preserves renal function in a patient with a solitary kidney, achieving social continence and improved quality of life.