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Virtual Pediatric Hospital: Paediapaedia: Ureteropelvic Duplications Paediapaedia: Genitourinary Diseases

Ureteropelvic Duplications

Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed


Clinical Presentation:
Urinary tract infection.

Etiology/Pathophysiology:
Duplication is the most common abnormality of the ureteropelvic collecting system. It is a congenital abnormality which covers a spectrum ranging from a simple bifid renal pelvis to a complete ureteropelvic duplication. Unilateral duplication is more common than bilateral duplication by 5:1, and incomplete duplication is more common than complete duplication by 2:1. When complete, duplicated ureters insert separately into the bladder, following the Weigert-Meyer rule which states that. the upper pole ureter is the ectopic ureter and its orifice inserts inferomedially in the bladder in relationship to the lower pole normal ureter. Reflux into the lower pole ureter is more common, presumably because the ureteral orifice is more laterally placed and follows a direct rather than oblique intramural course. The upper pole ureter is more commonly obstructed.

Pathology:
Not applicable

Imaging Findings:
An IVP nicely demonstrates the duplicated collecting system and ureters.

Ultrasound can nicely demonstrate the duplicated collecting system and has variable success in demonstrating the duplicated ureters.

DDX:

References:
See References Chapter.

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