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Incomplete double ureter

Case contributed by Vivek Pai
Diagnosis certain

Presentation

One month history of burning micturition. Ultrasound (not included) revealed a left sided double ureter but the entire course could not be traced. Hence an IVU was performed.

Patient Data

Age: 30 years
Gender: Female

Intravenous urography (IVU)

Fluoroscopy

Intravenous urography was performed which confirmed the ultrasound diagnosis of a left sided double ureter. The entire course of the ureters can be traced. The double ureters in this case is of the incomplete/partial variety.

  • 5 minute post-injection: left sided double ureters; entire course not fully demonstrated
  • post compression release: film demonstrating the entire course of the left ureters. The ureters are seen to fuse in the lower third of their course with only a single opening into the urinary bladder

Case Discussion

The Committee on Terminology, Nomenclature, and Classification of the Section on Urology of the American Academy of Pediatrics suggests:

  • duplex kidney: the duplex kidney has a single renal parenchyma that is drained by two pyelocaliceal systems
    • upper or lower pole: the poles represent one component of a duplex kidney
    • upper and lower pole ureters: upper and lower pole ureters drain a duplex kidney's upper and lower poles, respectively
  • duplex system: the kidney has two pyelocaliceal systems and is associated with a single ureter or with a bifid ureter (a partial duplication) or, in the case of a complete duplication, with 2 ureters (double ureters) that drain separately into the urinary bladder
  • bifid system: two pyelocaliceal systems join at the ureteropelvic junction (bifid pelvis), or 2 ureters join before draining into the urinary bladder (bifid ureters)
  • double ureters: two ureters open separately into the renal pelvis superiorly and drain separately into the bladder or genital tract

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