Bilateral partial ureteral duplication with double collecting system in horseshoe kidney

Area of Science:

• Urology
• Pediatric Urology
• Medical Imaging

Background:

• Horseshoe kidney represents the most frequent renal fusion anomaly, often presenting with other congenital abnormalities in about one-third of cases.
• The simultaneous occurrence of horseshoe kidney and bilateral ureteral duplication is exceptionally rare in clinical practice.

Observation:

• A patient presenting with urinary incontinence was incidentally diagnosed with horseshoe kidney during an ultrasound examination.
• Further investigation with intravenous pyelography (IVP) revealed a bilateral double collecting system and partial hydronephrosis, prompting advanced imaging.

Findings:

• The case highlights the rare association of horseshoe kidney with bilateral ureteral duplication.
• Diagnostic imaging, including IVP and magnetic resonance urography, confirmed the complex urinary tract malformations, including dilated renal pelvis and partial hydronephrosis.

Implications:

• This case underscores the importance of thorough diagnostic evaluation for congenital anomalies, even when symptoms like urinary incontinence appear unrelated.
• Recognizing such rare combinations is crucial for accurate diagnosis and appropriate management of complex renal and ureteral malformations.
• Advanced imaging techniques like MR urography are valuable for detailed delineation of intricate genitourinary anomalies.