Authors: Prakash, Thimmiah Rajini, Jayanthi Venkatiah...

PURPOSE

To study the prevalence of duplex system and double ureter in cadavers and intravenous pyelograms in Indian population.

MATERIALS AND METHODS

Fifty cadavers were dissected and 50 intravenous pyelograms were examined on both (right and left) sides for the presence of duplex system and double ureter.

RESULTS

One male cadaver aged 43 years showed complete double ureter and duplex system on the right side and incomplete double ureter and duplex system on the left side. Another male cadaver aged 56 years showed incomplete double ureter and duplex system only on the right side. An intravenous pyelogram of a 43-year-old man showed incomplete double ureter along with duplex system on the right side.

CONCLUSION

Developmental anomalies of the kidney, ureter, and urinary bladder should be kept in mind and promptly detected before the manifestations of aforementioned complications increase the morbidity of the affected individuals.

Topics: Adolescent; Adult; Aged; Female; Humans; Kidney Pelvis; Male; Middle Aged; Ureter; Urography; Young Adult

PubMed: 21656475
DOI: No ID Found

Review

Authors: Vladimir M Kozlov, Andreas Schedl

Congenital abnormalities of the kidney and urinary tract (CAKUT) are a highly diverse group of diseases that together belong to the most common abnormalities detected in the new-born child. Consistent with this diversity, CAKUT are caused by mutations in a large number of genes and present a wide spectrum of phenotypes. In this review, we will focus on duplex kidneys, a relatively frequent form of CAKUT that is often asymptomatic but predisposes to vesicoureteral reflux and hydronephrosis. We will summarise the molecular programs responsible for ureter induction, review the genes that have been identified as risk factors in duplex kidney formation and discuss molecular and cellular mechanisms that may lead to this malformation.

Topics: Child; Genetic Predisposition to Disease; Humans; Hydronephrosis; Kidney; Mutation; Vesico-Ureteral Reflux

PubMed: 32030122
DOI: 10.12688/f1000research.19826.1

Authors: Guoqing Liu, Xin Zhang, Xinyuan Yu...

BACKGROUND

Bilateral duplicated kidney and ureter is a rare condition in urology, and it is even rarer for patients to have multiple stones simultaneously. We delineate the diagnostic and therapeutic trajectory of a patient presenting with bilateral duplex kidneys and ureters, characterized by the presence of multiple stones. Notably, the left kidney is a complete duplication, whereas the right kidney exhibits an incomplete duplication.

CASE PRESENTATION

A 47-year-old male patient was diagnosed with bilateral duplex kidney and ureter combined with multiple stones. Ureteral flexible lithotripsy and percutaneous nephrolithotomy were performed successively in our hospital. On the postoperative five day, he was discharged from the hospital without apparent discomfort.The double J tube was pulled out one month later, and no stone recurrence was found after 3 months of follow-up.

CONCLUSIONS

Bilateral duplicated renal ureteral malformations combined with multiple stones are very rare. Stones can be removed by ureteroscopic lithotripsy or percutaneous nephrolithotripsy and sometimes multiple procedures are required, which should be chosen according to the patient's relevant condition.

Topics: Humans; Male; Middle Aged; Ureter; Kidney; Ureteral Calculi; Kidney Calculi; Nephrolithotomy, Percutaneous; Lithotripsy

PubMed: 39396019
DOI: 10.1186/s12894-024-01611-8

Authors: Lan Bu, Fang Nie, Yan Li...

BACKGROUND

The objective of our study was to share the experience of the ectopic ureter and to characterize associated clinical features, medical images, and management.

METHODS

A retrospective analysis was performed on 13 cases of ectopic ureter confirmed by surgery. The gender, age, abnormal urinary leakage, the site of the ectopic ureter, renal dysplasia, and surgical methods of the patients were compared and analyzed.

RESULTS

Eleven females and 2 males with ectopic ureters were analyzed. Eight cases had the clinical symptom of persistent or intermittent urine leakage since birth. One case was with complete persistent urine leakage, and 4 cases with no urine leakage. The site of the ectopic ureters was mostly unilateral. Ectopic ureters were located in the vagina in 6 cases, urethra in 4 cases, prostate in 1, and uncertain in 2 cases. There were 3 cases with ectopic kidney and renal atrophy, 3 cases had "Y" ureter, and 8 cases had repeated ureters with duplex kidneys. Twelve cases were treated with surgery, and 1 case underwent bilateral ureteral stent implantation. Three cases were complicated with ureteral stump syndrome after surgery.

CONCLUSIONS

The classic symptom of the ectopic ureter is continuous wetting with intermittent normal micturition in most young girl patients. Ectopic ureter is often associated with duplex kidneys, ectopic kidneys and atrophic kidneys. The surgical approach should be personalized. The aim of the surgery is to make the patient without urine leakage and preserve kidney function.

Topics: Male; Female; Humans; Ureter; Retrospective Studies; Kidney Pelvis; Ureteral Obstruction; Kidney Diseases; Kidney

PubMed: 36651090
DOI: 10.56434/j.arch.esp.urol.20227510.118

Personalized Surgical Management Offers Full Restitution and Unimpaired Quality of Life to Patients with Duplex Kidneys and Associated Pathologies: 30-year Follow-up at a Tertiary Referral Center.

Authors: Lidija Ujkic, Karsten Haeffner, Friederike Praus...

BACKGROUND

Duplex kidneys may be associated with additional pathologies with an indication for surgery. Various surgical approaches have been described. However, little is known about long-term outcomes and quality of life (QoL) for these patients.

OBJECTIVE

To present long-term outcomes and QoL data up to 30 yr after surgical treatment of duplex kidneys and associated pathologies.

DESIGN SETTING AND PARTICIPANTS

We collected clinical and operative data for all patients who underwent surgery for complicated duplex kidney at our institution from 1990 to 2018. All patients were invited for a follow-up examination or telephone interview.

OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS

We evaluated renal function, clinical outcomes, residual dilation of the upper urinary tract, and health-related QoL.

RESULTS AND LIMITATIONS

Of the 176 patients included, 173 were available for follow-up (mean 140.5 mo). Surgical treatment involved an upper-tract, lower-tract, or combined approach in 11%, 56%, and 33% of cases, respectively. Rates of perioperative complications (8%) and secondary surgery (10%) were low. Overall, 95% of our patients achieved full restitution. Renal function was preserved in all cases, with recurrent urinary tract infections reported by just 2% and urinary incontinence by 1%. Good health-related QoL was reported by 98% of patients. Those without full restitution included six patients who underwent total nephrectomy and two boys who underwent multiple surgeries and urinary diversion. Our results are limited by their retrospective nature, including partly incomplete data sets.

CONCLUSIONS

Management of duplex kidneys and associated pathologies is complex and highly individual. By planning a personal approach for each patient it is possible to achieve full bodily integrity and good QoL for most of these patients.

PATIENT SUMMARY

Almost all patients undergoing surgery for duplex kidneys and associated pathologies will lead a life without body impairment and good quality of life.This trial is registered in the German Clinical Trials Register as DRKS00022542.

PubMed: 38020523
DOI: 10.1016/j.euros.2023.09.012

Review

Authors: Aylin N Bilgutay, Andrew J Kirsch

Robot-assisted laparoscopic (RAL) surgery is a safe, minimally invasive technique that has become more widely used in pediatric urology over recent decades. With several advantages over standard laparoscopy, robotic surgery is particularly well-suited to reconstructive surgery involving delicate structures like the ureter. A robotic approach provides excellent access to and visualization of the ureter at all levels. Common applications include upper ureteral reconstruction (e.g., pyeloplasty, ureteropelvic junction polypectomy, ureterocalicostomy, and high uretero-ureterostomy in duplex systems), mid-ureteral reconstruction (e.g., mid uretero-ureterostomy for stricture or polyp), and lower ureteral reconstruction (e.g., ureteral reimplantation and lower ureter-ureterostomy in duplex systems). Herein, we describe each of these robotic procedures in detail.

PubMed: 30968006
DOI: 10.3389/fped.2019.00085

Authors: Shu-Bin Wang, Li Wan, Yong Wang...

BACKGROUND

Duplication of the renal pelvis is a common congenital malformation of the urinary system. About one-third of cases are complete unilateral duplication of the renal pelvis, while bilateral duplication is extremely rare. Herein, we described a single case of bilateral renal duplication with double ureteral orifice ectopic vaginal fistula treated with laparoscopy.

CASE SUMMARY

A 6-year-old girl suffering from long-term vaginal leakage was admitted on June 10, 2018. She was diagnosed with complete duplication of both kidneys and ureters and ectopic opening of both ureters combined with ureterovaginal fistula. The patient received laparoscopic ectopic ureteral bladder replantation and was followed up for 2 years. No renal function damage and vaginal leakage were found.

CONCLUSION

Laparoscopic bladder-ureter reimplantation could effectively determine the location and number of ectopic ureters by imaging and cystoscopy.

PubMed: 36159542
DOI: 10.12998/wjcc.v10.i23.8344

Authors: Guoqing Liu, Xin Zhang, Xinyuan Yu...

PubMed: 39574090
DOI: 10.1186/s12894-024-01642-1

Authors: Souhail Regragui, Amine Slaoui

Topics: Gastrointestinal Diseases; Humans; Kidney Pelvis; Ureter

PubMed: 28292161
DOI: 10.11604/pamj.2016.25.204.9529

Authors: Ubirajara O Barroso

Topics: Humans; Infant; Ureter; Ureteral Obstruction; Ureteroscopy; Vesico-Ureteral Reflux

PubMed: 33621010
DOI: 10.1590/S1677-5538.IBJU.2020.0742.1