[Two rare case reports of ureteral triplication]

Area of Science:

• Urology
• Pediatric Surgery
• Medical Genetics

Background:

• Ureteral triplication is an exceptionally rare congenital anomaly of the upper urinary tract, with fewer than 100 cases documented since its initial description.
• The condition is classified into four types based on its extent, with pediatric and female cases being less common.
• Embryologically, ureteral triplication arises from the development of multiple ureteral buds from the Wolffian duct, potentially involving fissuring.

Observation:

• This report presents two pediatric cases of ureteral triplication.
• The first case involved an extravesical ectopic ureter and a dysplastic kidney, presenting significant diagnostic challenges.
• The second case was associated with upper pole hydronephrosis.

Findings:

• The first case required a total nephrectomy due to the complexity of the associated anomalies.
• The second case was managed with a partial nephrectomy, addressing the upper pole hydronephrosis.
• These cases underscore the variability in presentation and management of ureteral triplication.

Implications:

• The rarity and diverse presentations of ureteral triplication necessitate a high index of suspicion for accurate diagnosis in pediatric patients.
• Management strategies for ureteral triplication must be individualized based on the specific associated anomalies and their severity.
• Further research into the embryological origins and long-term outcomes of ureteral triplication could improve clinical care.