Ureteric Stump Syndrome After Nephrectomy in a Patient With Rare Incidentally Detected Congenital Anomalies: A Case Report

Ureteral stump syndrome is one of the rare postoperative complications arising years after nephrectomy, particularly when the distal ureter is retained. It might remain undiagnosed due to vague symptoms mimicking a urinary tract infection. I came across one such case, which was associated with something other than genitourinary anomalies. Presenting a case of a 30-year-old female with a history of developed persistent vaginal discharge of pus, recurrent febrile episodes, and abdominal pain. The individual had undergone left-sided total nephrectomy at the age of 23 years for chronic pyelonephritis, which was a complication of ectopic ureter, but the distal ureteral segment was not excised. On USG and MRI, the collection of fluid was identified in the stump left behind during the previous surgery. Surgical excision confirmed ureteral stump syndrome. Incidentally, intraoperative findings showed an endometrial cyst. Also, this patient was presented with various anomalies suggestive of caudal regression syndrome, but other vertebral and minor cardiac anomalies also existed, which was the rarest association. This case underscores how crucial it is to remove the entire ureter when performing a nephrectomy for ectopic ureters to avoid further complications. It also brings attention to the often-overlooked diagnostic and emotional struggles that come with internal congenital anomalies, conditions that frequently slip through the cracks of health policies.