Undiagnosed ureterovaginal fistula in congenital duplex kidney with ectopic ureteric insertion to urethra; something to look for?

Continuous urinary incontinence in young female with normal voiding pattern should prompt proper assessment for ectopic ureter. We report a young female who presents with continuous urinary incontinence and malodour urine. She was frequently treated as recurrent urinary tract infection which subsequently referred to urology unit. Initial imaging revealed right duplex kidney with ectopic ureter, which she had undergone right heminephrectomy, however her symptoms does not improve significantly. Further evaluation revealed uretero – urethral fistula and uretero – vaginal fistula. She had then undergone urethroureteral and ureterovaginal fistula repair, which resolved her distressing urinary incontinence issue.