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Related Concept Videos

Disorders of the Urinary System01:20

Disorders of the Urinary System

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The urinary system is responsible for eliminating waste and excess fluids from the body. However, disorders of the urinary system can arise due to various reasons like infections, stress, age, congenital abnormalities, and lifestyle.
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Acute kidney injury (AKI) causes are categorized into three primary categories based on the location of the injury: prerenal, intrarenal (or intrinsic), and postrenal causes. This classification guides clinical management and illustrates how different pathways can impair kidney function.Etiology and Pathophysiology of Acute Kidney Injury1. Prerenal causesEtiology: Prerenal Acute Kidney Injury, the most common type, occurs when reduced blood flow to the kidneys decreases filtration capacity...
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Anatomy of the Genitourinary System I: Kidneys and Ureters01:11

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The upper urinary system comprises two kidneys and two ureters, which are crucial in filtering blood and forming urine.KidneysLocation and Structure:The kidneys are two bean-shaped organs positioned behind the peritoneum on either side of the spine.Kidneys are between the 12th thoracic (T12) and the 3rd lumbar (L3) vertebrae.The position of the liver causes the right kidney to sit slightly lower than the left.Protective Layers:Each kidney is enveloped in a tough, fibrous membrane called the...
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Urinary Tract Calculi II: Pathophysiology and Clinical Manifestations01:26

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Renal calculi, commonly termed kidney stones, are crystalline solid masses that form in the kidneys but can occur at any point within the urinary system, encompassing the kidneys, ureters, bladder, and urethra.The pathophysiology of renal stones involves several key factors: supersaturation of the urine with stone-forming constituents, changes in urine pH, a decrease in urine volume, and the presence of substances that promote or inhibit stone formation.Supersaturation of Urine: This is the...
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Acute Pyelonephritis I: Introduction01:27

Acute Pyelonephritis I: Introduction

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Pyelonephritis is a bacterial infection that primarily affects the renal parenchyma and collecting system, including the renal pelvis, tubules, and interstitial tissue of one or both kidneys. It can be classified as either acute—a sudden, severe infection—or chronic, which refers to long-term or recurrent kidney infections.The primary cause of acute pyelonephritis (APN) is bacterial infection, with Escherichia coli accounting for approximately 70-80% of cases. Other bacteria, such...
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Ureters01:22

Ureters

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The ureters are retroperitoneal tubes located on either side of the vertebral column. They are responsible for transporting urine from each kidney to the urinary bladder. These tubes have thick walls and are approximately 25-30 cm long. Their diameter is around 10 mm at the renal pelvis, gradually narrowing to 1 mm as the ureter obliquely enters the posterior bladder wall through the ureteric orifices. The shape of these orifices is slit-like, which helps to prevent urine backflow toward the...
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Assessing Urinary Tract Junction Obstruction Defects by Methylene Blue Dye Injection
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Obstructed bifid uretereric system causing unilateral hydronephrosis.

Amyn Bhamani1, Manoj Srivastava

  • 1Department of General Medicine, The Ipswich Hospital, Ipswich, United Kingdom.

Reviews in Urology
|November 14, 2013
PubMed
Summary

Bifid ureters, a common urinary system anomaly, rarely cause hydronephrosis. This case highlights a diagnostic challenge in an elderly patient with renal failure, where the anomaly was initially missed, complicating treatment.

Keywords:
Bifid uretersHydronephrosisNephrostomy

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Area of Science:

  • Urology
  • Medical Diagnostics
  • Anatomical Malformations

Background:

  • Bifid ureters are a frequent congenital anomaly of the urinary tract.
  • Obstruction leading to hydronephrosis from bifid ureters is an uncommon clinical presentation.

Purpose of the Study:

  • To report a rare case of hydronephrosis secondary to bifid ureters in an elderly male.
  • To discuss the diagnostic and therapeutic challenges posed by a missed diagnosis of bifid ureters.

Main Methods:

  • Case report of an 88-year-old male presenting with renal failure.
  • Incidental finding of bifid ureters during emergency nephrostomy for hydronephrosis.
  • Review of previous imaging (CT scan) that had not identified the anomaly.

Main Results:

  • The patient presented with symptoms of renal failure.
  • Bifid ureters were discovered incidentally in a hydronephrotic kidney during an emergency procedure.
  • The anomaly was not detected on a prior CT scan, leading to delayed diagnosis.

Conclusions:

  • This case underscores the rarity of bifid ureters causing significant urinary obstruction and hydronephrosis.
  • Diagnostic oversight in imaging can lead to complex therapeutic dilemmas in patients with congenital anomalies.
  • Increased vigilance for congenital urinary tract malformations is warranted, even in elderly patients.