Bilateral duplex collecting system with bilateral vesicoureteral reflux: a case report

Abstract

Background A bilateral duplex collecting system is an unusual renal tract abnormality. Vesicoureteral reflux may be associated. We describe a rare case of bilateral duplex collecting system with bilateral vesicoureteral reflux in which the refluxing ureter on the left side drains the upper pole moiety contrary to what is often found. Case presentation A 24-year-old married Arab woman presented with ascending left-sided flank pain during micturition. She complained of recurrent urinary tract infections. A physical examination and laboratory tests were normal. Voiding cystourethrography and computed tomography scan detected bilateral duplex collecting system, grade IV vesicoureteral reflux on the left side, and grade I vesicoureteral reflux on the right. She underwent left heminephrectomy and dextranomer/hyaluronic acid injections on the right side. After a year of follow-up, a clinical examination and imaging findings were unremarkable. Conclusions A bilateral duplex collecting system with refluxing upper pole moiety ureter is a very rare entity. The diagnosis should be suspected when exploring any flank pain with recurrent urinary tract infections to avoid subsequent renal impairment. Furthermore, this case shows how some common symptoms may lead to finding an unexpected urinary tract abnormality.

Laparoscopic management of double moiety: A case report with review of literature

“…The duplex collecting system is one of the most common urological anomalies. The incidence of duplex renal collecting systems is in the range of 0.5-3%, with females being more affected than males (2:1) [1]. The kidney is divided into various segments, each supplied by a single "end" arterial branch that arises from one of the main renal arteries.…”

“…The duplex collecting system refers to the kidney with two pelvicalyceal systems, which may have either a single or bifid ureter (partial duplication) or a double ureter draining separately into the urinary bladder (complete duplication). It may be associated with other abnormalities such as ureterocele, ectopic ureter, vesicoureteral reflux (VUR), or ureteropelvic junction obstruction (UPJO) [1]. An ureterocele is a congenital disorder that causes a submucosal cystic dilation of the terminal ureter.…”

Multi Imaging Modality in Diagnosis of Unusual Giant Hydronephrosis of the Non Functioning Lower Moiety in A Partial Duplex Kidney with Distal Ureteric Stricture

“…Depending on the degree of fusion, it can present as bifid renal pelvis, partial (incomplete) ureteric duplication with ureters joining proximally or near the bladder wall and complete ureteric duplication with separate ureteric orifices [7,8]. In complete duplex, the ureteral drainage pattern is normally governed by the Meyer-Weigert rule, predicting that the ureter of the upper part usually drains infero-medially into an ectopic location, and the lower ureter part usually drains supero-laterally to its normal insertion in the trigon [9,10]. In partial duplex kidney, it is associated with either retrograde peristalsis of urine as a result of pressure gradient between two ureteric segments termed as "Yo-Yo reflux" or pelvicureteric junction obstruction [11,12].…”

Giant hydronephrosis secondary to an ectopic ureter associated with bilateral duplex collecting system: a case report

“…Giant hydronephrosis mainly occurs as a result of an ureteropelvic junction obstruction (UPJO) and is rarely associated with a collecting system duplication [ 2 ]. Duplex collecting system is one of the most common urologic anomalies, it might be unilateral or bilateral, complete or partial and it may be associated with other abnormalities such as ureterocele, ectopic ureter, vesicoureteral reflux (VUR) or UPJO [ 3 ]. In this case, we will present a bilateral duplex collecting system; complete on the left side and partial on the right with a right ectopic ureteral orifice, in addition to bilateral VUR, which was accidently revealed by giant hydronephrosis.…”