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
- Pain
It starts with lower abdominal pain and swelling/bloating, then drops of yeast arrive and then pain sets in. I am still having lower back pain. [medhelp.org]
I hope your bladder pains resolve and that you get good answers very soon. [hystersisters.com]
Will my child receive pain medication? Many children get caudal or epidural nerve blocks — pain medications administered through tubes in the back — so they wake up without pain. [ucsfbenioffchildrens.org]
Pain from middle ureteral obstruction is referred to the inguinal, scrotal or mons pubis, and upper medial aspect of the thigh (L1, L2). Pain from lower ureteral obstruction is referred to the perineum (S2 S4). [earthslab.com]
Case 3 A 60-year-old woman presented with a 6-year history of bilateral lumbar pain and lower urinary tract symptoms. [ncbi.nlm.nih.gov]
- Asymptomatic
Even though most cases are initially asymptomatic, up to 50% of children with end-stage renal disease have an underlying CAKUT. For this reason, early identification of these malformations is essential in order to prevent renal damage. [amboss.com]
Most are asymptomatic, but some are accompanied by ectopic ureterocele. [medicinins_lt.enacademic.com]
They are usually asymptomatic and detected incidentally on imaging studies. Excretory urographic findings are almost always diagnostic. [casereports.bmj.com]
Double ureters may remain asymptomatic for the whole life of a person. Nonetheless, the condition is often complicated by recurrent urinary tract infection and calculi 7. [jemds.com]
- Fever
In children it may cause fever and systemic symptoms, but in adults it causes only cloudy, burning, and frequent urine. [healthofchildren.com]
Pain, bladder irritative symptoms, and fever are usually signs of early complications related to double-J stents; late complications are more troublesome. [ncbi.nlm.nih.gov]
Associated malformations may lead to urinary tract infections, fever or abdominal tumor Diagnostic Work-Up Sonography: Without associated malformations, a normal finding in renal ultrasound is often diagnosed. [urology-textbook.com]
It seems like it's in the area of the appendix but I know it's not that...this has been going on for too long and I don't get fevers. [healthboards.com]
These children typically don't have a fever with the infections. If you suspect that your child has an infection, please notify your child's pediatrician or the Pediatric Urology office at (415) 353-2200. [ucsfbenioffchildrens.org]
- Swelling
Well he wasn't sure if I have IC beacuse my ureter in the bladder swells to the sive of a golf ball. It was a suprise to me, I only have pain some times but badder infection sysmptoms at leats 3 times a month. [hystersisters.com]
Some other kidney birth defects may be associated with complete ureteric duplications, like swelling of upper part (hydronephrosis) or reflux of urine into the lower part. People with double ureters are prone to get urinary tract infections. [doctor.ndtv.com]
A ureter can become blocked due to numerous problems including kidney stones, tumors, thrombus, postsurgical swelling, or disease. A ureteral stent is positioned within the ureter to revive the movement of urine towards the bladder. [laparoscopyhospital.com]
It starts with lower abdominal pain and swelling/bloating, then drops of yeast arrive and then pain sets in. I am still having lower back pain. [medhelp.org]
Patients may suffer from early satiety, obstructive gastrointestinal symptoms, pain or lower extremity swelling. [karger.com]
- Surgical Procedure
Ureteral injury is a common complication of open or laparoscopic surgical procedures involving the abdomen and pelvic region. [cureus.com]
Sometimes preventive (prophylactic) antibiotics Sometimes surgical procedures Treatment depends on the specific birth defect and also on the severity of the complications. [msdmanuals.com]
Standard surgical procedure for an ileoureteroplasty consists of isolating an ileal duct of equal or greater length than the ureteral defect and interposing it in the urinary tract in an isoperistaltic direction. [panafrican-med-journal.com]
URETEROCELE: TUI reasonable to offer before more complex reconstructions, specially young infants. May make a subsequent surgical procedure less complex by decompressing a dilated upper pole ureter. [slideshare.net]
Gastrointestinal
- Abdominal Pain
Answered by: Dr Rajesh Ahlawat | Chairman Division of Urology and Renal Transplantation Medanta Kidney and Urology Institute Medanta, the Medicity Q: I am a 40 years old man who had severe abdominal pain 4 days back. [doctor.ndtv.com]
Risks Difficulties related to ureteral stenting include: bleeding (usually minor and easily treated, but occasionally requiring transfusion) catheter migration or dislodgement coiling from the stent inside the ureter (could cause lower abdominal pain [laparoscopyhospital.com]
It starts with lower abdominal pain and swelling/bloating, then drops of yeast arrive and then pain sets in. I am still having lower back pain. [medhelp.org]
non- lobulated. LATE PRESENTATION: Infection, abdominal/flank pain, Incontinence, Stone in ureterocele. 27. [slideshare.net]
Stent symptoms were observed in 65.2% of the cases (flank pain, abdominal pain, dysuria, and pyelonephritis). Nevertheless, no special consideration for stent length was taken to improve patient comfort during the study. [indianjurol.com]
- Vomiting
Droperidol or Compazine may be given for nausea, vomiting and pain. These medications may make your child drowsy. Some children react to pain medication by becoming overexcited and nervous or developing a rash. [ucsfbenioffchildrens.org]
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]
In children, it normally presents with pain and vomiting. A significant number will require intervention - some do not present with functional obstruction until adulthood. [patient.info]
- Nausea
Droperidol or Compazine may be given for nausea, vomiting and pain. These medications may make your child drowsy. Some children react to pain medication by becoming overexcited and nervous or developing a rash. [ucsfbenioffchildrens.org]
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]
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]
- Flank Pain
[…] or flank pain on urination, urinary frequency, or blood within the urine) introduction or deteriorating of infection penetration of surrounding organs (e.g., bowel, gallbladder, or lungs) Questions a patient should ask a doctor while meeting for treatment [laparoscopyhospital.com]
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]
non- lobulated. LATE PRESENTATION: Infection, abdominal/flank pain, Incontinence, Stone in ureterocele. 27. [slideshare.net]
Stent symptoms were observed in 65.2% of the cases (flank pain, abdominal pain, dysuria, and pyelonephritis). Nevertheless, no special consideration for stent length was taken to improve patient comfort during the study. [indianjurol.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]
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]