Extraurethral urinary incontinence in a patient with a congenital urogenital abnormality

Diagnosis and treatment of urinary incontinence generally pose no difficulties, as substantial global experience has been accumulated in solving this problem. However, the diagnosis of extraurethral urinary incontinence is relatively rare. It is crucial to remember that the mechanics of urination is a multi-component process, and the mechanisms of its impairment are extremely diverse. Thus, in determining a personalized treatment strategy, the clinician must consider the possible association of urinary symptoms with congenital urogenital abnormalities.

Patient B., 42, during her initial examination by an obstetrician-gynecologist, complained of involuntary urine leakage, unrelated to any factors contributing to urinary incontinence. Collecting her gynecological history revealed episodes of urinary incontinence since childhood, but the cause remained undetermined. In reproductive age, the patient experienced incontinence episodes up to twice a week but could stay “dry” for three weeks. Her obstetric history includes three normal full-term pregnancies, all of which ending in uncomplicated term deliveries. No diagnostic method provided complete information on any pathology.

Rare clinical cases like the one presented in this article can be influenced by incomplete diagnosis at one stage, errors in evaluating further examination results, and, as a consequence, incorrect surgical tactics and subsequent complications. Clinicians treating urinary incontinence in women must have a clear understanding of congenital urogenital abnormalities, their embryological development, as well as diagnostic and treatment options.