Prolapsed ureterocele mimicking a vulval mass in young female with complete duplex system and ureteral stone: A case report

INTRODUCTION AND IMPORTANCE: Ureterocele is a congenital malformation of the ureter with dilatation in the distal part of the ureter. In most cases, this condition was present in childhood. In cases involving adults, this condition is associated with prolapse as well as the formation of stones. Prolapsed ureterocele with stone is considered to be a very rare case. We report a complex case of prolapsed ureterocele in a young female with a protruding mass in the vagina with complete pyeloureteral duplication and stone in the left ureterovesical junction. CASE PRESENTATION: A 19-year-old female presented to the hospital with a complaint of protruding mass in the vagina. A Computed Tomography (CT) scan and Intravenous Urography (IVU) confirmed the presence of a left ureterocele with a complete duplex system and stone in the ureterovesical junction. An endoscopic resection of the ureterocele was performed. One year following surgery, the patient was asymptomatic without deterioration of renal function or urinary tract infection. DISCUSSION: Prolapsed ureterocele in adulthood mimicking the clinical appearance of vulvar mass is considered a very rare case. The imaging examination in this case can be identified through CT-Scan. Surgical treatment of ureterocele consisted of incision, multiple punctures, unroofing, or resection. Considering the complex presentation in this case, we decided to undergo endoscopic resection to prevent the incidence of re-prolapsed which later required a second procedure. CONCLUSION: In cases of prolapsed ureterocele associated with urethral stones, endoscopic treatment is a viable option for reducing the risk of recurrent ureterocele prolapse.