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Duplicated ureter

Duplicated ureterFrom Wikipedia, the free encyclopedia

Duplicated ureteror Duplex Collecting System is a congenital

condition in which the ureteric bud, the embryological origin of the

ureter, splits (or arises twice), resulting in two ureters draining a single

kidney. It is the most common renal abnormality, occurring inapproximately 1% of the population.[1][2]The additional ureter may

result in a ureterocele, or an ectopic ureter.

Contents

1 Pathophysiology

2 Classification

3 Prevalence

4 Clinical Presentation

5 References

6 See also

Pathophysiology

Ureteral development begins in the human fetus around the 4th week of embryonic development. A uretericbud, arising from the mesonephric (or Wolffian) duct, gives rise to the ureter, as well as other parts of the

collective system. In the case of a duplicated ureter, the ureteric bud either splits or arises twice. In most case

he kidney is divided into two parts, an upper and lower lobe, with some overlap due to intermingling of

collecting tubules. However, in somecases the division is so complete as to give rise to two separate parts, e

with its own renal pelvis and ureter.

Classification

Ureteral duplication is either:

Partial- i.e. the two ureters drain into the bladder via a single common ureter. Partial, or incomplete,

ureteral duplication is rarely clinically significant.[2]

or

Complete- in which the two ureters drain separately. Complete ureteral duplication may result in one
http://en.wikipedia.org/wiki/File:Duplicated_ureter.svghttp://en.wikipedia.org/wiki/Urinary_bladderhttp://en.wikipedia.org/wiki/Renal_pelvishttp://en.wikipedia.org/wiki/Duplicated_ureter#Classificationhttp://en.wikipedia.org/wiki/File:Duplicated_ureter.svghttp://en.wikipedia.org/wiki/File:Duplicated_ureter.svghttp://en.wikipedia.org/wiki/File:Duplicated_ureter.svghttp://en.wikipedia.org/wiki/File:Duplicated_ureter.svghttp://en.wikipedia.org/wiki/Ureterocelehttp://en.wikipedia.org/wiki/Ectopic_ureterhttp://en.wikipedia.org/wiki/File:Duplicated_ureter.svghttp://en.wikipedia.org/wiki/Duplicated_ureter#cite_note-duplex_collecting_system-1http://en.wikipedia.org/wiki/Duplicated_ureter#cite_note-emedicine-2http://en.wikipedia.org/wiki/Congenital_disorderhttp://en.wikipedia.org/wiki/Duplicated_ureter#cite_note-emedicine-2http://en.wikipedia.org/wiki/Urinary_bladderhttp://en.wikipedia.org/wiki/Renal_pelvishttp://en.wikipedia.org/wiki/Wolffian_ducthttp://en.wikipedia.org/wiki/Human_embryogenesishttp://en.wikipedia.org/wiki/Duplicated_ureter#See_alsohttp://en.wikipedia.org/wiki/Duplicated_ureter#Referenceshttp://en.wikipedia.org/wiki/Duplicated_ureter#Clinical_Presentationhttp://en.wikipedia.org/wiki/Duplicated_ureter#Prevalencehttp://en.wikipedia.org/wiki/Duplicated_ureter#Classificationhttp://en.wikipedia.org/wiki/Duplicated_ureter#Pathophysiologyhttp://en.wikipedia.org/wiki/Ectopic_ureterhttp://en.wikipedia.org/wiki/Ureterocelehttp://en.wikipedia.org/wiki/Duplicated_ureter#cite_note-emedicine-2http://en.wikipedia.org/wiki/Duplicated_ureter#cite_note-duplex_collecting_system-1http://en.wikipedia.org/wiki/Kidneyhttp://en.wikipedia.org/wiki/Ureterhttp://en.wikipedia.org/wiki/Ureteric_budhttp://en.wikipedia.org/wiki/Congenital_disorderhttp://en.wikipedia.org/wiki/File:Duplicated_ureter.svg


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One of a series of IVP films at 15

minutes after injection of contrast

medium showed incomplete

duplication of left collecting system

ureter opening normally into the bladder, and the other being ectopic, ending in the vagina, the urethra

the vulval vestibule. These cases occur when the ureteric bud arises twice (rather than splitting).[3]

Prevalence

Duplicated ureter is the most common renal abnormality, occurring in approximately 1% of the population.[2

Race: Duplicated ureter is more common in Caucasians than in African-Americans. Sex: Duplicated ureter imore common in females. However, this may be due to the higher

frequency of urinary tract infections in females, leading to a higher rate

of diagnosis of duplicated ureter.

Clinical Presentation

Prenatally diagnosed hydronephrosis (fluid-filled kidneys) suggest post-

natal follow-up examination. The strongest neo-natal presentation is

urinary tract infection. A hydronephrotic kidney may present as apalpable abdominal mass in the newborn, and may suggest an ectopic

ureter or ureterocele. In older children, ureteral duplication may present

as:

Urinary tract infection - most commonly due to vesicoureteral

reflux (flow of urine from the bladder into the ureter, rather than

vice versa).

Urinary incontinence in females occurs in cases of ectopic ureter

entering the vagina, urethra or vestibule.

References

1. Siomou E. et al, Duplex collecting system diagnosed during the first 6 years of life after a first urinary tract infection

study of 63 children (http://www.medscape.com/medline/abstract/16407023), Journal of Urology, 2006; 175(2):678-

discussion 681-2

2. J. Gatti, J. Murphy, J. Williams, H. Koo, emedicine overview, Ureteral Duplication, Ureteral Ectopia, and Ureterocel

(http://emedicine.medscape.com/article/1017202-overview)

3. Sadler, T. W., Langman's medical embryology - 11th ed. p. 240, ISBN 978-0-7817-9069-7.

See also

Ureterocele

Ectopic ureter

Kidney development
http://en.wikipedia.org/wiki/Kidney_developmenthttp://en.wikipedia.org/wiki/Ectopic_ureterhttp://en.wikipedia.org/wiki/Ureterocelehttp://en.wikipedia.org/wiki/Special:BookSources/9780781790697http://emedicine.medscape.com/article/1017202-overviewhttp://www.medscape.com/medline/abstract/16407023http://en.wikipedia.org/wiki/Urinary_incontinencehttp://en.wikipedia.org/wiki/Vesicoureteral_refluxhttp://en.wikipedia.org/wiki/Urinary_tract_infectionhttp://en.wikipedia.org/wiki/Hydronephrosishttp://en.wikipedia.org/wiki/Urinary_tract_infectionhttp://en.wikipedia.org/wiki/Duplicated_ureter#cite_note-emedicine-2http://en.wikipedia.org/wiki/Duplicated_ureter#cite_note-3http://en.wikipedia.org/wiki/Vulval_vestibulehttp://en.wikipedia.org/wiki/Urethrahttp://en.wikipedia.org/wiki/Vaginahttp://en.wikipedia.org/wiki/Ectopic_ureterhttp://en.wikipedia.org/wiki/File:IVP_Duplication.jpg


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