Ureteric duplication

Facial dysmorphism, pterygium colli, distended abdomen, absence of external genitalia and of anal and urethral openings, polycystic kidneys, dysmorphism of lumbar spine Unilateral ureteral duplication with one ureter ending in the vagina, hydronephrosis, hydroureters... 

Prune belly syndrome Deficient abdominal muscles, urinary obstruction/ distension, cryptorchism, malrotation of the gut, clubfeet, limb reduction anomalies Urethral atresia, ureteral duplication, bladder distension, hydronephrosis, renal dysplasia Mostly sporadic, heterogeneous (100100)... 

Kaufmann-McKusick syndrome Hydrometrocolpos, transverse vaginal membrane, vaginal septum, postaxial polydactyly, cardiac anomalies, hypospadias Hydroureter, ureteral duplication, ectopic urethra, urogenital sinus, posterior urethral valves AR (236700), mutations in Bardet-Biedl type 6 BBS6 gene... 

Daniels MA, Allen TA (1994) Unsuspected ureterocele and ureteral duplication. JUrol 152 179-181 Dixon JS, Canning DA, Gearhart JP et al (1994) An immuno-histochemical study of the innervation of the UVJ in infancy and childhood. Br J Urol 73 292-297 Duckett JW (1993) When to operate on neonatal hydronephrosis. Urology 42 617-619... 

Patriquin H (1991) Doppler examination of the kidney in infants and children. Urol Radiol 12 220-227 Patti G, Menghini ML, Tordini AR et al (2000) The role of the renal resistive index ratio in diagnosing obstruction and in the follow-up of children with unilateral hydronephrosis. BJU Intern 85 308-312 Peppas DS, Skoog SJ, Canning DA et al (1991) Nonsurgical management of VUR in complete ureteral duplication. JUrol 146 1594-1595... 

Ureteric Duplication, Ureteric Ectopia, and Associated Anomalies 341... 

In most cases incomplete ureteric duplication is an incidental finding. However, it is occasionally possible that there is yo-yo reflux leading to stasis and ureteric dilatation. This can lead to flank pain and infection. In the rare cases requiring surgery, the type of operation depends on the level of duplication. If this is very low, it may be possible to carry out a reimplantation of the ureters with separate ureteric orifices into the bladder. If the duplication is higher, a high ureteropyelostomy or ureteroureterostomy with excision of most of the duplicated ureter is the treatment of choice. 

The treatment of ureteric duplication depends on the level of duplication and the presence or absence of associated reflux. 

General Considerations 110 Duplication and VUR 110 Ureteral ectopia 110 Ureterocele 111... 

Cope RM, Snow BW (1991) Massive cystic ureteral diverticula in infancy. J Urol 146 575-577 CorralesJG, Elder JS (1996) Segmental multicystic kidney and ipsilateral duplication anomalies. J Urol 155 1398-1401 Cremin BJ (1986) A review of the US appearances of posterior urethral valves and ureteroceles. Pediatr Radiol 16 357-364... 

Holthusen W, Lundius B (1984) Megapolycalycosis with ureteric obstruction. Ann Radiol 27 191-196 Husmann D, Strand B, Ewalt D et al (1999) Management of ectopic ureterocele associated with renal duplication. J Urol 162 1406-1409... 

Another causal factor in enuresis nocturna might be rapid bladder Ailing (N0rgaard et al. 1989). In this context the rare anatomic abnormality of a completely duplicated ureteral system in which an ectopic ureter empties directly outside the bladder has to be kept in mind. In this case the upper renal moiety drains through a ureter that empties below the urethral sphincter or at some other ectopic site such as the vagina, uterus or even the perineum. Hence, these children are wet all of the time. This condition occurs exclusively in girls. 

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