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Unsuspected ureterocele and ureteral duplication
1University of Texas Southwestern Medical Center, Dallas.
The Journal of Urology
|July 1, 1994
Summary
High-grade unilateral vesicoureteral reflux can mask a duplex system with a ureterocele. Retrospective review revealed subtle signs, highlighting the need for consideration in similar cases.
Area of Science:
- Pediatric Urology
- Radiology
- Surgical Anatomy
Background:
- Vesicoureteral reflux (VUR) is a common condition in pediatric urology.
- High-grade unilateral VUR presents a diagnostic challenge.
- Duplex systems and ureteroceles are congenital anomalies that can affect renal function.
Observation:
- Four patients with high-grade unilateral VUR were found intraoperatively to have an unsuspected duplex system.
- The duplex system included a ureterocele associated with the upper pole of the refluxing kidney.
- Preoperative radiographic studies did not definitively diagnose the duplication or ureterocele.
Findings:
- Retrospective analysis of preoperative imaging revealed subtle indicators of duplication and ureterocele in some cases.
- The association of duplex systems and ureteroceles with high-grade unilateral VUR was unexpected.
- This rare anatomical configuration was not diagnosed preoperatively through standard imaging.
Implications:
- Consideration of duplex systems with ureteroceles is crucial for cases of massive unilateral VUR.
- Enhanced retrospective imaging review may identify subtle signs missed preoperatively.
- Early recognition can potentially improve surgical planning and patient outcomes.