To explore the experiences of laparoscopic reconstructive operation in the treatment of distal ureteral Y-shaped ectopic orifice with urinary incontinence in children with incomplete duplex kidney.

A retrospective analysis was made on the clinical data of a baby girl with bilateral distal ureteral Y-shaped ectopic orifice with urinary incontinence with incomplete duplex kidney. She was admitted to hospital for "leakage of urine and repeated urinary sensation for 6 months" in this study.CT examination: Bilateral duplex kidney and ureteral malformation,bilateral duplex hydronephrosis and ureter tortuous dilation, right lower group hydronephrosis and dilated ureters obvious, and bilateral duplex ureters may have ectopic opening. Retrograde urethrography through ectopic opening of ureter in vulva: Right duplex hydronephrosis and hydroureter, a same ectopic opening of right repeated ureters in vulva. Diuretic nephrography: Total effective renal plasma flow of both kidneys=71.42 ml/min, relative uptake ratio of bilateral renal function: L=74.6% (upper group kidney 16.22%, lower group kidney 58.38%), R=25.2% (upper group kidney 9.52%, lower group kidney 15.88%). Cystoscopy: Urethral orifice, vaginal orifice and right Y-shaped ectopic ureter opening can be seen in labia minora, and continuous overflow of urine from the ectopic opening can be seen, the same left ureter opening can be seen near the bladder neck on the left side of internal orifice of urethra. She was treated under general anesthesia with laparoscopic right end-to-side ureterostomy combined with ureterovesical replantation.One month after the operation, she returned to the hospital for reexamination and removed the D-J tube. Six months later,laparoscopic left ureteral end-to-side anastomosis combined with ureter bladder replantation was performed.

The operation was successfully completed. The continuity and patency of bilateral upper urinary tract were restored by laparoscopic reconstruction. Follow up of over 1 year, her bilateral duplex hydronephrosis and hydroureter were significantly alleviated, and there was no obvious urinary incontinence.

Laparoscopic end-to-side ureteral anastomosis combined with ureter bladder replantation is a safe and effective minimally invasive method for the treatment of Y-type ectopic orifice of distal ureter with urinary incontinence in children with incomplete duplex kidney. It can save the patients with renal function of upper and lower components of the kidney, and completely solve the urinary incontinence caused by ectopic ureteral orifice.