Duplex System with Ectopic Ureter Opens into the Posterior Urethra: Case Report

Abstract

IntroductionDuplicated ureter or Duplex Collecting System is a congenital condition in which the ureteric bud, the embryological origin of the ureter, arises twice, resulting in two ureters draining a single kidney. This congenital anomaly is rare, and even rarer when the duplex system with ectopic ureter is present. This type of congenital anomaly is even more rarely diagnosed and surgically treated in adulthood.Case reportThis case report presents a case of a 32-year-old male, who had a duplex collecting system with two ureters on the left side. Ectopic ureter, draining the upper pole of the left kidney, opened into the posterior urethra. In our patient, taking into account the clinical perspective, the renal tissue damaging of the upper pole which was not functional, partial nephrectomy and ureterectomy was successfully performed.

Duplication of pelvicalyceal system: A rare diagnosis made reliably by use of volume rendering technique on a 384 slice CT machine

“… Most duplicated systems are asymptomatic and diagnosed incidentally. However, where symptoms do occur (infection, reflux or obstruction), the patient is likely to have completely duplicated ureters [4] .  As such duplex kidney usually does not require any treatment, however, if complications occur intervention may be required.…”

Ectopic insertion of a duplicated ureter into the prostatic urethra

“…La DU incompleta no suele ocasionar síntomas, ni daño renal alguno y su diagnóstico con frecuencia es incidental. (2) La Ley de Weigert-Meyer explica la DU completa. Plantea que el uréter que surge del polo inferior del riñón se inserta más cefálico y lateral en la vejiga y presenta un curso intramural corto que predispone al reflujo ureteral y el uréter que surge de la porción del polo superior, se inserta más caudal y medial, con frecuencia desarrolla un ureterocele y se asocia a obstrucción.…”

“…Es frecuente en el sexo femenino con una proporción 6:1, con respecto al masculino. (1)(2)(3) A su vez, la inserción ureteral ectópica (IUE) es una entidad rara cuya incidencia se estima del 0.05 al 0.025%. Con frecuencia se presenta con duplicidad ureteral (DU).…”

“…En el hombre la inserción es siempre supraesfinteriana: en el cuello vesical, las vesículas seminales, el conducto deferente, la próstata o el epidídimo. (2,4) La IUE se presenta, frecuentemente, de forma asintomática. Su diagnóstico es incidental, sin embargo, en edades tempranas suele presentarse con hidronefrosis, infecciones re-currentes del tracto urinario e incontinencia de orina, que obligan al estudio del paciente y su diagnóstico.…”

Duplicated collecting system with ectopic prostatic implantation: Therapeutic conservative robot assisted approach, about a case report

“…However, conservative treatment is not always possible. Milicevic et al, 5 reported the case of a patient with left ureteral duplication with ectopic lower ureter involvement in the posterior urethra, who underwent a superior polar nephrectomy since the upper renal was not functional.…”