The tale of twice left behind: laparoscopic excision of dual symptomatic ureteric stumps

Abstract

Ureteric stump syndrome is a rare complication post-nephrectomy characterized by persistent urinary symptoms, often secondary to reflux or infection of the residual ureteric tissue. The presence of dual symptomatic ureteric stumps is an extraordinarily rare phenomenon. We report a case of successful laparoscopic management of dual refluxing ureteric stumps in an adult female with complex urogenital anatomy, including an ectopic ureter. A 31-year-old woman with a history of left ureteric reimplantation for an ectopic ureter opening into the bladder neck and vagina underwent laparoscopic nephrectomy for a poorly functioning kidney. She developed recurrent urinary tract infections (UTIs) and persistent symptoms despite nephrectomy. Imaging revealed dilated ureteric stump on non-contrast computed tomography (CT). During laparoscopic surgery, two dilated ureteric stumps were identified and excised completely. Postoperative recovery was uneventful with complete symptom resolution. This case highlights the diagnostic and surgical challenges posed by dual ureteric stumps and supports laparoscopic completion ureterectomy as a safe and effective treatment for refractory ureteric stump syndrome.