Ureteral Triplication Research Articles

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

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.

A case of ureteral triplication associated with ureteropelvic junction obstruction

Ureteral triplication is one of the rarest malformations of the upper urinary tract. The association of ureteral triplication and obstruction is even rarer. We report a case of ureteral triplication associated with hydronephrosis due to ureteropelvic junction (UPJ) obstruction at the middle pole ureter. To our knowledge, such a malformation has not been described previously.

Ureteral Triplication - Report of Four Cases

Four cases of ureteral triplication in children are described. In one case ureteral triplication was detected incidentally and it was not accompanied by any other pathology of the urinary tract. In the three remaining cases there were pathologies of the urinary system (reflux, obstruction) that demanded surgical treatment. The literature concerning this rare anomaly is reviewed.

Ureteral triplication: A case report

Of all children born with congenital anomalies, 30-40% have urogenital abnormalities. Most of them are asymptomatic, but if any symptoms occur, they are usually symptoms of urinary infections. A four-year old girl was admitted because of recurrent urinary infections and in order to perform a thorough clinical examination. Clinical examination showed an asymmetrical gluteus and presence of a fibroma in the same region. Detailed radiologic examinations (ultrasonography, plain X-ray, excretory urography, voiding urethrocystography) revealed a triplicate ureter on the right side with a vesicoureteral reflux of the fifth grade on the same side. Intraoperatively, type III ureteric triplication according to Smith's classification was established. Ureteral remodeling and reimplantation was done. The postoperative course was good, and follow-up voiding urethrocystography showed absence of reflux. Ureteral triplication is a consequence of either development of three buds on the mesonephric duct, or development of two buds, one of which further divided into two parts. Most common anomalies associated with ureteral triplication are: ureteral duplication on the other side (37%), ectopy of the ureteric orifice (28%) and kidney dysplasia (8%). Vesicoureteral reflux is very common on affected or on both sides. Symptomatology is the same as in ureteral duplication--dominated by signs of urinary infections. Diagnosis of ureteral duplication requires detailed imaging. Treatment of symptomatic abnormalities should be individual, regardless of the applied treatment (conservative or operative).

Unilateral ureteral triplication with duplex kidney and megaureter

We report a case of duplex kidney with Type-2 ureteral triplication, with one megaureter having stenosis at its lower end and dysplasia of the upper moiety of the kidney. The child presented with lump abdomen and recurrent attacks of urinary tract infection. The child underwent excision of the dysplastic part of the kidney and megaureter with an ureteroureterostomy connecting the normal caliber lower ureter (U3) draining in trigone with the mildly dilated middle ureter (U2) draining into the megaureter (U1) of the upper moiety. The patient is well 2 months postoperatively with no urinary infection and stable renal function.

Ureteral triplication: the first report in China

Ureteral triplication is a rare congenital anomaly of the urinary tract. Since the first description of ureteral triplication by Wrany in 1870, only about 100 cases have been reported in the literature. Pediatric cases are very few. Here, 2 cases of ureteral triplication were reported. Diagnosis was established preoperatively in 1 case and intraoperatively in 1. To the authors knowledge, this is the first report of ureteral triplication in China.

À propos de deux cas rares de triplication urétérale

Triplication of the upper urinary tract is rare. It is classified according to its extent and four types have been documented. Since the first description of ureteral triplication by Wrany only about a hundred cases have been reported in the literature. Paediatric cases are very few and female patients seem more concerned. The embryological event resulting in ureteral triplication derives from multiple ureteral buds arising from the Wolffian duct with fissuring of one or more of them. We report on two cases of ureteral triplication. The first one associated with an extravesical ectopic ureter and a dysplasic kidney. Diagnosis was particularly difficult and treatment consisted of total nephrectomy. The second case was associated with an upper pole hydronephrosis and a partial nephrectomy was realized.

URETERAL QUADRUPLICATION WITH CONTRALATERAL TRIPLICATE URETER

While duplication of the urinary tract is common, ureteral triplication is rare and ureteral quadruplication is exceedingly unusual. Less than 100 cases of ureteral triplication have been reported in the literature and to our knowledge only 4 cases of ureteral quadruplication have been reported.1, 2 We report a case of ureteral quadruplication with contralateral triplicate ureter. Review of the literature failed to reveal documentation of such a case.

Ureteral triplication with ectopic upper pole moiety

Ureteral triplication with ectopic upper pole moiety

Triplicación ureteral con reflujo vesicoureteral y duplicación contralateral

We report a new case of ureteral triplication (type I in Smith’s classification) with a grade V/V vesicoureteral symptomatic reflux to the lower group and non-functional renal parenchima in this part of the kidney, associated with contralateral ureteral duplication. It was treated by left lower pole nephroureterectomy.

Type ii ureteral triplication associated with ectopic ureter

We report a case of type II ureteral triplication associated with ectopic ureter. The ureter, draining the upper renal segment, entered the vagina, and the other two ureters, draining the middle and lower renal segments, had joined and entered the bladder. The anatomic findings are compatible with those predicted by the Weigert-Meyer law. A thorough evaluation of such an anomaly is essential for effective management.

Ureteral triplication and ureterocele: Report of three cases and review of the literature : R. Gosalbez, Jr, R. Gosalbez, C. Piro, et al. J Urol 145:105–108, (January), 1991

Ureteral triplication and ureterocele: Report of three cases and review of the literature : R. Gosalbez, Jr, R. Gosalbez, C. Piro, et al. J Urol 145:105–108, (January), 1991

Ureteral Triplication and Ureterocele: Report of 3 Cases and Review of the Literature

We report 3 cases of ureterocele associated with ureteral triplication and review the literature. Ureteral triplication was type I in 2 patients and type II in 1. Diagnosis was established preoperatively in 2 cases and intraoperatively in 1. All patients were initially treated by upper pole partial nephrectomy and aspiration of the ureterocele, leaving the ureteral stump open in the retroperitoneum. Subsequent excision of the ureterocele and ureteral reimplantation for persistent ipsilateral vesicoureteral reflux and recurrent urinary tract infections were required in 2 cases.

Ureteral Triplication: Double Extra Vesical Ureteral Ectopia

A 21-month-old girl presented with ureteral triplication, representing an exceptional variant of Smith’s type 1. One ureter was intravesical and the other 2 were extravesical (bladder neck and vaginal).

Bilateral Ureteral Triplication with Crossed Ectopic Fused Kidneys Associated with the Vacterl Syndrome

We report a case of bilateral ureteral triplication associated with crossed ectopic fused kidneys, vesicoureteral reflux and the VACTERL syndrome (Vertebral defects, Anal atresia, Cardiovascular anomalies, Tracheo-Esophageal fistula, Radial and renal anomalies, and Limb defects). The relevant literature is reviewed.

Type I Ureteral Triplication: An Extension of the Weigert-meyer Law

We report a case of type I ureteral triplication and document the locations of the ureteral orifices corresponding to the renal segments. The ureter from the uppermost renal segment issued onto the urethrovaginal septum and caused wetting. The wetting was cured by high ureteroureterostomy, Our findings are consistent with those expected by the Weigert-Meyer law.

Ureteral Triplication, Contralateral Duplication and Bilateral Extra Vesical Ectopic Ureter

A case of ureteral triplication associated with contralateral ureteral duplication and bilateral extravesical ectopic ureter is reported. The child presented with urinary incontinence. The incidence, classification and embryology of triplication are reviewed.

Complete ureteral triplication with ectopia

A case of complete ureteral triplication is reported and a brief review of the literature is presented.

Ureteral Triplication and Duplicated Opposite Kidney With Refluxing Ureterocele

Ureteral Triplication and Duplicated Opposite Kidney With Refluxing Ureterocele

Ureteral triplication and duplicated opposite kidney with refluxing ureterocele

A case is reported of ureteral triplication with ectopia of two of the ureters and contralateral duplication with a ureterocele. This patient is the youngest that we have found reported with this type of anomaly and the only one presenting with abdominal distention and an intact but refluxing ureterocele.