Presentation and Diagnosis of Ureteral Quadruplication: Case Report and Analysis of the Literature

Right-sided Zinner syndrome with a left side quadrupled ureter– a case report

“…Patients with Zinner syndrome remain asymptomatic for a long time, and there is a strong correlation between sexual activity and the onset of symptoms [5] . On the opposite, patients with quadrifid ureter may experience recurrent UTI [6 , 9 , 10 , 11] Many cases of quadruplication of ureter have an association of ipsilateral ureteral cyst [6] , but our case lacks such findings. Accompanied vertebral abnormalities such as hemivertebrae are also observed with genitourinary anomalies, [15] as in our case.…”

“…Quadruplication of a ureter is an extremely rare anomaly [7 , 10] . Up to date, only 15 cases have been reported in English literature and 11 of them had surgical treatment by ureteral reconstruction, excision or implantation of ureter, nephrectomy, or heminephrectomy [6] .…”

“…Most of the patients with ureteric quadruplication have recurrent UTI [6 , 9 , 10 , 11] . In our case, the patient was complaining of left flank pain and dysuria for a week.…”

“…And, quadruplication of the ureter, an exceedingly rare anomaly is the existence of 4 incomplete ureters. About 15 cases have been reported up to now [6] and only 3 cases were known until early 1994 [9] . There are about 100 cases of triplication of the ureter reported in the literature [6] .…”

“…About 15 cases have been reported up to now [6] and only 3 cases were known until early 1994 [9] . There are about 100 cases of triplication of the ureter reported in the literature [6] . Theoretically, the presence of more than one ureteric bud may result in multiple ureters [7 , 14] .…”