The Interrelationship between Vesico-ureteric Reflux, Trigonal Abnormalities and a Bifid Pelvicalyceal Collecting System: a Family Study

Abstract

3 investigations have been undertaken to study the interrelationship between a bifid pelvicalyceal collecting system, vesico-ureteric reflux and lateral ectopia of the ureteric orifice. Firstly, in 30 families investigated to confirm the familial incidence of bifid and double ureters there were 3 families in which siblings were found with primary reflux. Secondly, reflux was found in 62 of 110 patients investigated with a duplex pelvicalyceal system. Reflux was to the ipsilateral kidney in 48 patients but occurred to the contralateral kidney, unaffected by duplicity, in 14. This high incidence of reflux is related to lateral ectopia of the ureteric orifice which may be either bilateral or unilateral. Thirdly, the incidence of a bifid pelvicalyceal system was determined in the parents and siblings of a series of 32 patients with primary reflux. The results support the hypothesis that primary reflux may be inherited by an autosomal dominant gene of variable penetrance in a manner similar to the inheritance of a duplex urinary tract. Thus there is a direct genetic relationship between primary vesico-ureteric reflux, lateral ectopia of the ureteric orifices and a duplex pelvicalyceal system.

Polydimethylsiloxane (macroplastique®) injection for vesicoureteral reflux in duplex ureters: A comparison with single renal systems

“…VUR has an incidence of 56% in patients with DS and occurs in the lower moieties in 75% of cases [15]. It is uncertain whether spontaneous resolution of VUR is less likely in complete DS.…”

The Paraureteric Diverticulum in Childhood

“…Associated anomalies in our series included 4 patients with double ureters, representing a 19fold increase over the incidence in the normal population. The significance of this finding is probably related to the method of inheritance of duplicated ureters (Whitaker and Danks, 1966;Atwell et al, 1974) and to the relationship between this and the inheritance of other congenital anomalies of the urinary tract (Atwell et al, 1977). There were 4 megaureters in this series but it is not possible to say whether they were primary or whether they were secondary to reflux.…”

Primary, Nonsyndromic Vesicoureteric Reflux and Nephropathy in Sibling Pairs

“…Duplex kidney was noted in nine patients in the U.K. cohort. The incidence of duplication in the general population is approximately 2% (50) and VUR and duplex kidney can coexist in an individual (51). Families have also been described in which some members can have either VUR or duplex kidney (51).…”