Vaginal cysts are a common finding. The differential diagnosis includes epidermal inclusion, Bartholin gland, Gartner duct, and Skene gland cysts and Müllerian anomalies. Rarely, leiomyomas, cancers, or ectopic ureters or megaureters are found.
A 31-year-old woman, gravida 3 para 3, presented with a 12-year history of intermittent abdominal pain and involuntary loss of urine. She was diagnosed with ectopic vaginal megaureter after evaluation and subsequently underwent a nephroureterectomy with a marsupialized distal ureter. She remains asymptomatic.
Consideration of a rare diagnosis such as an ectopic ureter is important when patients repeatedly present with involuntary urinary incontinence in conjunction with a vaginal cyst and an otherwise negative evaluation. Using magnetic resonance imaging can be useful to assess urinary tract involvement, particularly in patients with known urinary tract malformations.
Congenital megaureter with ectopic vaginal insertion presents in an adult woman as a vaginal wall cyst with cyclic pain and discharge.
Uniformed Services University of the Health Sciences, and Walter Reed National Military Medical Center, Bethesda, Maryland.
Corresponding author: Allison A. Eubanks, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814, e-mail: firstname.lastname@example.org.
Financial Disclosure The authors did not report any potential conflicts of interest.