Case Report: Ureteral Quadruplication Associated with Ureteral Cyst and Massive Vesicoureteral Reflux Treated by Laparoscopic Nephroureterectomy

Abstract

Ureteral quadruplication is an extremely unusual developmental abnormality. We present the eighth reported case but the first to be associated with a ureteral cyst, with massive vesicoureteral reflux that was treated with laparoscopic nephroureterectomy. A 3-year-old boy was evaluated for recurrent urinary-tract infection. Massive left-sided vesicoureteral reflux associated with incomplete ureteral triplication was identified. A DMSA scan disclosed impaired function of this kidney. An uneventful total laparoscopic nephroureterectomy was performed at which a fourth atresic ureter was identified. All the four proximal ureters opened into a large ureteral cyst, and a distal monoureter opened into the bladder. The patient recovered fully and was asymptomatic 6 months postoperatively.