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Lancet (London, England) Mar 1988
Topics: Female; Humans; Male; Ureter
PubMed: 2893926
DOI: No ID Found -
Cureus Jan 2020Duplex ureter, an embryological developmental anomaly, can lead to intra-operative injuries, even by surgeons with a stronghold on normal ureteric anatomy. We describe...
Duplex ureter, an embryological developmental anomaly, can lead to intra-operative injuries, even by surgeons with a stronghold on normal ureteric anatomy. We describe the first case of an ectopic ureter transected during vaginal hysterectomy performed for pelvic organ proplase, due to its abnormally low implantation into the bladder, worsened by cystocoele. The injury was recognised, and the duplex ureter was diagnosed with cystoscopy and retrograde pyelography. A post-operative computed tomography urogram allowed us to map the exact course. In this case, there was injury to the ectopic, non-functional ureter, thus averting any further intervention. However, lower urinary tract injuries are serious complications with high morbidity, especially during delayed diagnosis. Knowledge of the ureter variants, meticulous tracing of the course, and use of post-operative cystoscopy could reduce these complications, particularly in face of increasing minimally invasive approaches.
PubMed: 32064179
DOI: 10.7759/cureus.6597 -
Radiographics : a Review Publication of... 2021The upper urinary tract is the most common human system affected by congenital anomalies. Congenital anomalies of the kidneys and ureters comprise a wide spectrum of... (Review)
Review
The upper urinary tract is the most common human system affected by congenital anomalies. Congenital anomalies of the kidneys and ureters comprise a wide spectrum of disorders ranging from simple variants with no clinical significance to complex anomalies that may lead to severe complications and end-stage renal disease. They may be classified as anomalies of renal form, which are subclassified as structural anomalies (eg, persistent fetal lobulation, hypertrophied column of Bertin, and dromedary hump) and fusion anomalies (eg, horseshoe kidney and pancake kidney); anomalies of renal position (eg, renal malrotation, simple renal ectopia, and crossed renal ectopia) and renal number (eg, renal agenesis and supernumerary kidney); and abnormalities in development of the urinary collecting system (eg, pyelocaliceal diverticulum, megacalycosis, ureteropelvic junction obstruction, duplex collecting system, megaureter, ectopic ureter, and ureterocele). US is usually the first imaging modality used because of its low cost, wide availability, and absence of ionizing radiation. Intravenous urography and voiding cystourethrography are also useful, mainly for characterization of the collecting system and vesicoureteral reflux. However, intravenous urography has been replaced by CT urography and MR urography. These imaging methods not only allow direct visualization of the collecting system but also demonstrate the function of the kidneys, the vascular anatomy, adjacent structures, and complications. Comprehension of congenital anomalies of the upper urinary tract is crucial for an accurate diagnosis and correct management. The authors discuss the spectrum of these anomalies, with emphasis on embryologic development, imaging findings, clinical manifestations, and complications. RSNA, 2021.
Topics: Humans; Kidney; Ureter; Urinary Tract; Urogenital Abnormalities; Urography
PubMed: 33513074
DOI: 10.1148/rg.2021200078 -
Cureus Mar 2022The ureters are muscular tubes that carry urine from the kidneys to the urinary bladder and are typically implanted in the superolateral angle of the trigone of the...
The ureters are muscular tubes that carry urine from the kidneys to the urinary bladder and are typically implanted in the superolateral angle of the trigone of the urinary bladder. Although renal anomalies are common, especially in the kidneys, ectopia of the ureter is rare. Clinical presentation depends on the insertion of the ectopic ureter, varying from asymptomatic (mostly in males) to recurrent urinary tract infections (UTIs) and incontinence (mostly in females). Radiology is the best diagnostic tool to achieve a diagnosis. Ultrasound (US), intravenous renogram (IVR), micturition cystourethrogram (MCUG), and others are used to diagnose ectopic ureters, with US and MCUG being the gold standard modalities. Treatment depends on the functionality of the part drained by the ectopic ureter. Heminephroureterectomy and ureteroureterostomy are among surgical treatments for ectopic ureter, and it is either open or laparoscopic surgery. Herein, we present a case of a four-year-old female patient who presented with recurrent UTIs and incontinence.
PubMed: 35505745
DOI: 10.7759/cureus.23609 -
Prenatal Diagnosis Nov 2001Duplex kidneys occur in 0.8% of the general population, many of whom are asymptomatic. Children with duplex kidneys may be prone to urinary tract infections because of... (Review)
Review
Duplex kidneys occur in 0.8% of the general population, many of whom are asymptomatic. Children with duplex kidneys may be prone to urinary tract infections because of vesico-ureteric reflux or obstruction. Surgical management is usually required once symptoms occur. Increasing numbers of duplex kidneys are now prenatally diagnosed by ultrasound, resulting in the development of early postnatal strategies to try and reduce morbidity.
Topics: Child; Child, Preschool; Humans; Infant; Kidney Calices; Ultrasonography, Prenatal; Ureter; Vesico-Ureteral Reflux
PubMed: 11746148
DOI: 10.1002/pd.206 -
IJU Case Reports Mar 2022The reimplantation of an ectopic ureter is still performed as an open surgery, although laparoscopic or robot-assisted laparoscopic surgery has gained popularity as a...
INTRODUCTION
The reimplantation of an ectopic ureter is still performed as an open surgery, although laparoscopic or robot-assisted laparoscopic surgery has gained popularity as a minimally invasive treatment for pediatric urological disorders.
CASE PRESENTATION
A 15-day-old Japanese boy was referred to our hospital with right hydronephrosis. A detailed examination revealed complete ureteral duplication on the right side and a dilated ectopic upper pole ureter, opening into the prostatic urethra. Since the patient had recurrent febrile urinary tract infections, we performed plication and ureteral reimplantation of the dilated ectopic ureter using a transvesicoscopic surgical method at the age of 2 years and 5 months.
CONCLUSION
We safely performed transvesicoscopic ureteral reimplantation for an ectopic upper pole ureter with a mate ureter in a duplex kidney, following the detection of an ectopic ureter within the bladder, due to the prior understanding of the wrapping of both ureters in a common sheath.
PubMed: 35252800
DOI: 10.1002/iju5.12401 -
Ultraschall in Der Medizin (Stuttgart,... Aug 2022Duplex kidneys have two renal pelvises and two ureters, which can join on the way to the urinary bladder but can also enter the bladder separately. A distinction must be...
Duplex kidneys have two renal pelvises and two ureters, which can join on the way to the urinary bladder but can also enter the bladder separately. A distinction must be made between normal and pathological duplex kidneys. In normal duplex kidneys, both renal pelvises are normal in width, and the upper and lower poles are approximately the same size. Furthermore, ureters are not dilated, and the upper and lower poles of the kidneys are not cystically altered. In contrast, pathological duplex kidneys, occurring in about 50 % of cases, are characterized by dilation of one or both renal pelvises. Additionally, one or both ureters may be dilated. Megaureters may be obstructive or refluxive. If a megaureter is present, a ureterocele must be ruled out, as well as an ectopically opening ureter. A pathological duplex kidney must always be assumed if one pole of the kidney is hypoplastic. Hypoplasia of the upper renal pole is often associated with an obstructive megaureter. Vesicoureteral reflux into the lower pyelon is common in hypoplasia of the lower pole. In the presence of vesicoureteral reflux, the associated (lower) pyelon is dilated when the bladder is full or during micturition. In addition, there is a dilated ureter. On the other hand, the pyelon can have a normal width when the bladder is empty. In rare cases, one pole may be cystically altered in pathological duplex kidneys. In this instance, segmental multicystic dysplastic duplex kidney must be differentiated from segmental multicystic nephroma.
Topics: Diagnosis, Differential; Humans; Kidney; Ureter; Ureterocele; Vesico-Ureteral Reflux
PubMed: 35488089
DOI: 10.1055/a-1749-5136 -
Journal of Medical Imaging and... Apr 2015Duplex kidneys are common, mostly asymptomatic and of no clinical significance. However, they can be associated with significant pathology, often with long-term... (Review)
Review
INTRODUCTION
Duplex kidneys are common, mostly asymptomatic and of no clinical significance. However, they can be associated with significant pathology, often with long-term morbidity. There is minimal literature on the review of the duplex kidney, its associated anomalies and complications. The purpose of this paper is to review our experience of imaging the spectrum of abnormalities associated with duplex kidneys in the paediatric population and correlate this with contemporary literature.
METHOD
A retrospective review of the radiology database in a tertiary paediatric centre was performed. A word search of the Radiology Information System for 'duplex' of patients under the age of 16 was undertaken and limited to studies performed between 2006 and 2013.
RESULTS
Two hundred seventy-four patients were identified (age range 0-16, median 3 years, gender 59.9% female) who had 836 studies: ultrasound 598/836 (71.6%), nuclear medicine 180/836 (21.5%), micturating cystourethrogram 52/836 (6.2%), MRI 5/836 (<1%) and CT scan 1/836 (<1%). Patients were categorised as duplex and no complication (151/274 = 55.1%), upper moiety obstruction, lower moiety reflux/scarring, multicystic dysplastic kidney, abnormal ureteric insertion and other pathology.
CONCLUSION
Duplex kidneys are common and often not clinically significant. However, this study demonstrates almost 50% of paediatric patients investigated for duplex kidneys had complications requiring treatment. The most common complications were upper moiety obstruction associated with a ureterocele and lower moiety vesicoureteric reflux. Ultrasound was the most common modality for early detection of these complications.
Topics: Abnormalities, Multiple; Adolescent; Age Distribution; Australia; Child; Child, Preschool; Diagnostic Imaging; Humans; Infant; Infant, Newborn; Kidney; Male; Prevalence
PubMed: 25708100
DOI: 10.1111/1754-9485.12285 -
Case Reports in Urology 2022Ureteral duplication is a common embryologic abnormality of the kidney with an incidence rate of 0.8% in adults. However, complete duplex ureters opening independently...
Ureteral duplication is a common embryologic abnormality of the kidney with an incidence rate of 0.8% in adults. However, complete duplex ureters opening independently into the urinary bladder are rarely present. We report a 35-year-old female who presented with left flank pain in the last three years. Abdominal CT scan showed left complete duplicated system with lower moiety hydroureteronephrosis and obstructed midureteral stone. The patient underwent left retroperitoneal exploration with complete excision of the hydronephrotic sac. The postoperative course was uneventful without complications. In conclusion, a complete duplex kidney with lower moiety hydronephrosis caused by mid ureteric stone is rare. The renal duplication system should be diagnosed and followed with image guidance periodically as the late diagnosis may have poor outcomes with loss of the kidney or part of it.
PubMed: 35464824
DOI: 10.1155/2022/6552889 -
International Urogynecology Journal Apr 2022
Topics: Female; Humans; Kidney; Male; Transplants; Ultrasonography; Ureter; Ureteral Obstruction
PubMed: 34988619
DOI: 10.1007/s00192-021-04898-5