Presentation
A 31-year-old multigravid woman with a history of severe endometriosis involving the urogenital tract and complete duplication of the right renal collecting system, as well as a right ureterovaginal fistula, presented for evaluation and surgical consult [ncbi.nlm.nih.gov]
Double ureter may present as either complete or incomplete/partial duplication [2,3]. [cureus.com]
Aberrant renal arteries are present in about 30% of individuals. Aberrant renal arteries to the inferior pole cross anteriorly to the ureter and may cause hydronephrosis [ 8 ]. [pulsus.com]
Entire Body System
- Recurrent Urinary Tract Infection
The accompanying malformations and symptoms guide the therapy (vesicoureteral reflux, ureterocele, ectopic ureter, recurrent urinary tract infections or urinary tract obstruction). [urology-textbook.com]
We report a case of recurrent urinary tract infections due to partial duplication of the collecting system in which yo-yo reflux is demonstrated with color and pulse wave Doppler. [mjmsr.net]
If a ureterocele is not detected on a prenatal ultrasound, it may not be detected until the child has recurrent urinary tract infections. [stanfordchildrens.org]
Nonetheless, the condition is often complicated by recurrent urinary tract infection and calculi 7. The bifid or double ureter may be due to disturbances during early development. [jemds.com]
urinary tract infections [ 9, 12 ]. [panafrican-med-journal.com]
Cardiovascular
- Hypertension
The clinical significance of mild-grade proteinuria and hypertension seen in some patients is unknown [ 3 ]. [patient.info]
A 41-year-old male, known to have hypertension on amlodipine, has presented to our hospital with bilateral recurrent colicky flank pain several weeks. The patient had a history of the spontaneous passage of several stones during the past years. [urologyannals.com]
As with lower pole hemi-nephrectomy the laparoscopic procedure is challenging, with risks of retroperitoneal fluid collection, loss of renal tissue and hypertension. [pediatricurologybook.com]
Psychiatrical
Neurologic
- Confusion
It's so confusing when there's different things going on!! I'm anxious to hear from you. Does any of this sound like what you go through? Let me know when you find out and good luck again! DMS P.S. [healthboards.com]
Your child may cry, be fussy or confused, feel sick to his or her stomach, or vomit. These reactions are normal and will go away as the anesthesia wears off. [chp.edu]
Overview Background Ureteral abnormalities represent a complex and often confusing subset of urologic anomalies that manifest in many ways. [emedicine.medscape.com]
Supernumerary kidneys Third kidney is extremely rare and not to be confused with the relatively common unilateral duplication of the renal pelvis. It may be found incidentally or during investigation of other anomalies. [patient.info]
Urogenital
- Incontinence
Individuals so affected may have incontinence or hydroureter/hydronephrosis, sometimes complicated by infection. [mcgill.ca]
If you accidentally dislodge the stent, you will temporarily be incontinent of urine. If this occurs, please put on a pad and call your doctor for advice during business hours. Important Information! [kidneystoneclinic.com.au]
This may be the cause of continuous urinary incontinence in females. In boys, all of the wolffian structures are located above the external urinary sphincter, and incontinence does not occur. [emedicine.medscape.com]
[…] deferens, seminal vesicles, or ejaculatory duct. No incontinence, but infection and pain of affected organs (testicles and epididymis). 7. [slideshare.net]
- Urinary Incontinence
CAS PubMed Google Scholar Braverman, R.M., Lebowitz, R.L. (1991) Occult ectopic ureter in girls with urinary incontinence. Diagnosis by using CT. AJR 156, 365–366. [link.springer.com]
Urinary incontinence in females occurs in cases of ectopic ureter entering the vagina, urethra or vestibule. [en.wikipedia.org]
QoL and psychological implications in women with urogynecological problems (e.g. urinary incontinence, sexually transmitted diseases) undergoing surgery have been examined in several research studies [ 5, 6 ]. [karger.com]
- Ureteral Disorder
Ureteral Disorders Your kidneys make urine by filtering wastes and extra water from your blood. The urine travels from the kidneys to the bladder in two thin tubes called ureters. The ureters are about 8 to 10 inches long. [icdlist.com]
- Bladder Spasm
After this type of surgery, it's common for children to experience bladder spasms or intermittent cramping, urinary frequency, urinary incontinence and to lose small amounts of blood-tinged urine. [ucsfbenioffchildrens.org]
- Urinary Retention
The procedure carries a risk of urinary retention, with 5% of children requiring a further two weeks of an indwelling urinary catheter and one patient requiring 6 weeks of intermittent catheterization (30). [pediatricurologybook.com]
Treatment
The patient underwent laparoscopic ureteroneocystostomy and vesicopsoas hitch for the treatment of infiltrative endometriosis with a double ureter. [ncbi.nlm.nih.gov]
Treatment for vesicoureteral reflux VUR may go away with no treatment in some children, which is more likely in younger children and in less severe cases. Antibiotics are generally the first treatment to stop the UTI. [denverurology.com]
[…] before treatment, in order to result in the ureters easier identifiable in the course of complicated surgical treatments. [laparoscopyhospital.com]
Ureteric stents are in most instances temporary and must be removed from the body after definitive treatment is completed. Occasionally, events can occur where communication and follow up is lost. [kidneystoneclinic.com.au]
They occur in 1 percent of the population, and most cause no medical problems and will require no treatment. [chop.edu]
Prognosis
Treatment and prognosis Surgical intervention is usually not indicated in absence of reproductive difficulties. [radiopaedia.org]
Prognosis As long as damage to the kidneys from infection or back pressure has not become significant, the surgical repair of troublesome ureteral defects produces excellent long-term results in the great majority of cases. [healthofchildren.com]
Finally, combined treatment modalities and complete management of the disease can give the patient a better prognosis and an increased chance of survival. [karger.com]
With appropriate management, the ultimate prognosis of duplicated ureter, ureteral ectopia, or ureterocele is excellent. Pathophysiology Ureteral embryology is fundamental in understanding abnormal development of the ureter. [emedicine.medscape.com]
Etiology
Rank WB, Mellinger GT, Spiro E (1960) Ureteral diverticula: etiologic considerations. J Urol 83: 566–569 Google Scholar Copyright information Authors and Affiliations O Cussenot 1 2 F Desgrandchamps 2 P Teillac 2 A Lesourd 3 1. [link.springer.com]
Etiology Clinical features Diagnostics Ultrasound imaging of the kidneys and bladder First-line imaging modality Detects anatomical abnormalities Renal ultrasound is warranted for all children with recurrent UTIs or UTI in children < 24 months of age. [amboss.com]
Epidemiology of the Duplex Kidney Prevalence 1:150 (0.67%) Etiology of the Duplex Kidney Two ureteral buds: The reason for a complete ureteral duplication are two ureteral buds on the mesonephric duct (Wolffian duct). [urology-textbook.com]
Epidemiology
Epidemiology Present in ~5% (range 1-10%) of the population 1-2. [radiopaedia.org]
Epidemiology of the Duplex Kidney Prevalence 1:150 (0.67%) Etiology of the Duplex Kidney Two ureteral buds: The reason for a complete ureteral duplication are two ureteral buds on the mesonephric duct (Wolffian duct). [urology-textbook.com]
Epidemiology United States statistics In autopsy series, the incidence of ureteral duplication is estimated at slightly less than 1%. In studies of young children with UTIs, the incidence of duplication rises to 8%. [emedicine.medscape.com]
EPIDEMIOLOGY Incidence of ureteral duplication- 1% (autopsy series). Ureteroceles- 1 per 5000-12000 population; 10% bilateral, 60-80% ectopic, 80% a/w upper-pole ureter of a duplex system. [slideshare.net]
Pathophysiology
Pathophysiology [ edit ] Ureteral development begins in the human fetus around the 4th week of embryonic development. [en.wikipedia.org]
CrossRef CAS PubMed Google Scholar Koff, S.A. (1990) Pathophysiology of ureteropelvic junction obstructions. Urol. Clin. North. Am. 17, 263–272. [link.springer.com]
Pathophysiology Ureteral embryology is fundamental in understanding abnormal development of the ureter. Ureteral development begins as early as 4 weeks' gestation. [emedicine.medscape.com]
PATHOPHYSIOLOGY & EMBRYOLOGY Ureteral bud branch from mesonephric/Wolffian duct Extends into nephrogenic blastema(undifferentiated mesenchyma) Formation of the entire renal collecting system Distal to ureteric bud, mesonephric duct incorporates into UGS [slideshare.net]
Prevention
Close monitoring and follow-up is very important and may contribute to the prevention of complications in these patients. [ncbi.nlm.nih.gov]
If symptoms are not too severe, doctors sometimes give children daily preventive antibiotics to prevent infection. Children with more severe symptoms usually need surgery to correct the problem and ensure urine drains properly. [msdmanuals.com]
Prevention The cause of congenital ureter anomalies is not known. There is no prevention. Resources BOOKS Colberg, John W. "Urologic Abnormalities of the Genitourinary Tract." Chapter 21, section 16, in Rudolph's Pediatrics, 21st ed. [healthofchildren.com]