Ureteral duplication anomalies: two years' experience in a single center

Area of Science:

• Pediatric Urology
• Genitourinary Anomalies
• Congenital Abnormalities

Background:

• Ureteral duplication is a common congenital anomaly of the genitourinary system.
• It presents with diverse clinical manifestations, posing diagnostic and therapeutic challenges for pediatric urologists.
• Variations include incomplete and complete duplications with normally developed renal moieties and ureters.

Purpose of the Study:

• To report institutional experience with the spectrum of ureteral duplication anomalies.
• To analyze clinical presentation, diagnostic workup, and management strategies.
• To evaluate outcomes of surgical interventions for selected cases.

Main Methods:

• Retrospective single-center study of pediatric patients with ureteral duplication anomalies (January 2019 - January 2021).
• Utilized preliminary renal ultrasonography (RUS), serum urea and creatinine.
• Further evaluated with voiding cystourethrography (VCUG), magnetic resonance urography (MRU), and dimercaptosuccinate (DMSA) renal scintigraphy for functional assessment.

Main Results:

• Included 28 children with renal duplex anomalies.
• Diagnoses included ectopic obstructing megaureter (4), lower moiety refluxing ureter (6), refluxing ureters in both moieties (3), and ureterocele (13).
• One rare case of a duplex system draining with a single ureteric opening was identified.

Conclusions:

• Ureteral duplications, ectopia, and ureteroceles are variable and challenging clinical entities.
• A conservative management approach may be considered due to the lack of a standard protocol.
• Detailed imaging is crucial; a bottom-to-top approach aided functional nephron recruitment, with ureteroureterostomy and laparoscopic heminephroureterectomy proving safe and feasible.