Duplicated ureter
Duplicated ureter or duplex collecting system is a
Pathophysiology
Ureteral development begins in the human fetus around the 4th week of
Diagnosis
Prenatally diagnosed hydronephrosis (fluid-filled kidneys) suggest post-natal follow-up examination. The strongest neo-natal presentation is urinary tract infection. A hydronephrotic kidney may present as a palpable abdominal mass in the newborn, and may suggest an ectopic ureter or ureterocele. In older children, ureteral duplication may present as:[citation needed]
- Urinary tract infection – most commonly due to vesicoureteral reflux (flow of urine from the bladder into the ureter, rather than vice versa).
- Urinary incontinence in females occurs in cases of ectopic ureter entering the vagina, urethra or vestibule.
Classification
Ureteral duplication is either of:
- Partial
- I.e., the two ureters drain into the bladder via a single common ureter. Partial, or incomplete, ureteral duplication is rarely clinically significant.[2]
- Complete
- In which the two ureters drain separately. Complete ureteral duplication may result in one ureter opening normally into the bladder, and the other being ectopic, ending in the vagina, the urethra or the vulval vestibule. These cases occur when the ureteric bud arises twice (rather than splitting).[3]
Prevalence
Duplicated ureter is the most common renal abnormality, occurring in approximately 1% of the population.[2] It occurs in about 0.7% of healthy adults and in 2% to 4% of people with urinary tract issues.[4]
- Race
- Duplicated ureter is more common in African-Americans.[citation needed]
- Sex
- Duplicated ureter is more common in females. However, this may be due to the higher frequency of urinary tract infections in females, leading to a higher rate of diagnosis of duplicated ureter.[citation needed]
Complications
A duplicated ureter increased the risk of:[4]
See also
References
- ^ Siomou E. et al, Duplex collecting system diagnosed during the first 6 years of life after a first urinary tract infection: a study of 63 children, Journal of Urology, 2006; 175(2):678-81; discussion 681-2
- ^ a b c J. Gatti, J. Murphy, J. Williams, H. Koo, emedicine overview, Ureteral Duplication, Ureteral Ectopia, and Ureterocele
- ISBN 978-0-7817-9069-7.
- ^ a b "Duplex Kidney". Clevelandclinic. Reviewed: 12/04/2020