Ureteral duplication is a comparatively frequent urinary tract anomaly. Ureteral triplication is rare, but quadruplication is extremely rare. In this study, we describe a case of ureteral quintuplication, the first such report in the Englishlanguage literature. A newborn female baby was diagnosed with left ureteral quintuplication. The left ureter was divided into 5 ureters with 5 renal pelvises within approximately 3 cm of the urinary bladder, and trace parenchyma of the kidney was noted. The patient was born within 60 km of the epicenter of the 1986 Chernobyl disaster, 24 years after the catastrophic nuclear accident, and is currently aged 3 years. UROLOGY 83: 211e213, 2014. Ó 2014 C ongenital anomalies of the kidney and urinary tract constitute approximately 20%-30% of all anomalies identified in the prenatal period. 1 Defects can be bilateral or unilateral, and different defects often coexist in a single child.Congenital anomalies of the kidney and urinary tract occur at a frequency of 1 in 500 live births and are a common cause of renal insufficiency in childhood. They encompass a wide spectrum of malformations, including anomalies of the kidney, collecting system, bladder, and urethra. 2 Worldwide statistics indicate that they are a cause of end-stage renal failure in children in 30%-43% of cases, 3 and the rate increases to 60% when the earlier stages of chronic kidney disease are considered. 4 Although ureteral duplication is a comparatively frequent urinary tract anomaly, identified in 0.32%-0.8% of the population, triplication is rare, and quadruplication is extremely rare. Until 2001, only 5 cases were described in the English-language literature, most of which involved incomplete multiplication and associated additional urinary tract malformations. In this study, we report a case of ureteral quintuplication and present postoperative photos. This is the first such report in the Englishlanguage literature.
CASE REPORTThe patient is a 3-year-old girl who was born within 60 km of the epicenter of the 1986 Chernobyl disaster (Ukraine), 24 years after the catastrophic nuclear accident. The mother lived in Owrucz, within 60 km of Chernobyl, during her pregnancy and was in the area of the epicenter when the urinary tract system of the infant would have developed.Prenatal ultrasound scans at 15-16 HBD (ie, week of pregnancy; from the Latin, hebdomen) showed urine retention in the right kidney of the fetus. Repeat ultrasound at 34 HBD showed malformation syndrome consistent with polycystic disease of the right kidney and digestive tract pathology of unknown etiology. Caesarean section was performed at 36 weeks' gestational age because of intrauterine infection and fetal asphyxia. The infant's birth weight was 2380 g, and the Apgar score was 1. After birth, the baby was admitted to the intensive care unit, where antibiotics were administered and diagnosis of malformations was initiated. Postnatal diagnoses included oesophageal atresia with tracheo-oesophageal fistula, biliary atresia, hydronephrosis of the righ...