Prenatal imaging features and postnatal outcomes of isolated fetal duplex renal collecting system: A systematic review and meta‐analysis

Bascietto, F.; Khalil, Asma; Rizzo, Giuseppe; Makatsariya, Alexander; Buca, Danilo; Silvi, Claudia; Ucci, Matteo Antonio; Liberati, Marco; Familiari, Alessandra; D’Antonio, F.

doi:10.1002/pd.5622

Cited by 6 publications

(3 citation statements)

References 35 publications

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“…One (1%) female child in our cohort was diagnosed with vesicoureteral reflux and recurrent UTIs, a rate similar to that of the general population and in agreement with other studies that reported a low rate of urinary vesicoureteral reflux complicated by UTIs among children [18][19][20][21][22]. Interestingly, a meta-analysis, which included 11 studies with 284 fetuses who were diagnosed with isolated DCS [23], reported a significant proportion of vesicoureteral reflux and urinary tract infections postnatally. However, renal pelvis dilatation was present in many cases, and 41% of the fetuses had worsening pelvic/ureteric dilatation over the course of the pregnancy, which could affect the outcome.…”

Section: Discussionsupporting

confidence: 91%

Fetal Renal Duplicated Collecting System at 14–16 Weeks of Gestation

Khatib,

Bronshtein,

Bachar

et al. 2023

JCM

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(1) Background: To examine the incidence of the prenatal diagnosis of the renal double-collecting system (rDCS) and describe its clinical outcome and associated genetic abnormalities. (2) Methods: This retrospective study included women who attended the obstetric clinic for early fetal anatomic sonography with findings of a renal DCS. Diagnosis was conducted by an expert sonographer using defined criteria. (3) Results: In total, 29,268 women underwent early ultrasound anatomical screening at 14–16 weeks, and 383 cases of rDCS were diagnosed (prevalence: 1:76). Associated abnormalities were diagnosed in eleven pregnancies; four had chromosomal aberrations. No chromosomal abnormalities were reported in isolated cases. Ectopic uretrocele and dysplastic kidney were diagnosed in 6 (1.5%) and 5 (1.3%) fetuses, respectively. One girl was diagnosed with vesicoureteral reflux and recurrent UTIs, and two boys were diagnosed with undescended testis. The recurrence rate of rDCS was 8% in subsequent pregnancies. (4) Conclusions: In light of its benign nature, we speculate that isolated rDCS may be considered a benign anatomic variant, but a repeat examination in the third trimester is recommended to assess hydronephrosis.

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Section: Discussionsupporting

confidence: 91%

Fetal Renal Duplicated Collecting System at 14–16 Weeks of Gestation

Khatib,

Bronshtein,

Bachar

et al. 2023

JCM

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“…Most of the urinary congenital abnormalities are diagnosed with antenatal USG, one of which is duplex system anomalies. Many studies in the literature show that approximately 70% of patients diagnosed with the prenatal duplex system are associated with ureterocele [6]. The presence of a duplex system presents questions surrounding VUR.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Pediatric Patients with a Diagnosis of Ureterocele

et al. 2022

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Aim: The presence and clinical importance of vesicoureteric reflux in patients with a double collecting system are being questioned. Therefore, the role of voiding cystourethrography in the management of patients with ureterocele is unclear. This study aimed to evaluate patients with a ureterocele in terms of urinary tract infection (UTI) and vesicoureteral reflux (VUR). Material Methods: The cases who were admitted to the Pediatric Nephrology Clinic of Health Sciences University Tepecik Training and Research Hospital between 2012 and 2022 and were diagnosed with ureterocele were evaluated retrospectively. Demographic, clinical, and laboratory data were obtained from file records. Results: All patients diagnosed with ureterocele and voiding cystourethrography (VCUG) were evaluated. A total of 24 (female 13 (54.2%)) children were included. The reasons for admission were antenatal hydronephrosis in 13 (54.2%) patients, UTI in 9 (37.5%) patients, and incidentally diagnosed ureterocele in 2 (8.3%) patients. Urinary tract infection was observed in 20 patients at admission, recurrent UTI in 21 patients at follow-up, preoperative pyelonephritis in 12 patients. VUR was found in 11 patients, and severe VUR (≥stage 3) was found in 9 patients. Ten patients had ipsilateral hydronephrosis, and 14 patients had a double collecting system. The presence of VUR was found to be associated with female gender, UTI at admission, and recurrent UTI at follow-up (p < 0.05). However, there was no difference between groups with or without VUR in terms of ipsilateral hydronephrosis, scar formation, and the need for surgery (p > 0.05). Conclusions: We could not demonstrate any criteria to select patients to receive VCUG; on the other hand, VUR did not cause more kidney damage. Our study supports the need for more scientific data to determine management in patients with ureterocele.

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“…DCS is one of the most common congenital anomalies of the urinary tract (UT), accounting for 0.7-1% of all anomalies [4]. It is characterized by a duplex kidney, where every unit acts as a separate pelvicalyceal system that finally drains into the bladder via either a complete or an incomplete collecting system.…”

Section: Introductionmentioning

confidence: 99%

Management of Upper Tract Urothelial Carcinoma in a Double Collecting System Kidney

Zohar,

Sivan,

Mintz

et al. 2024

JPM

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Upper tract urothelial carcinoma (UTUC) in a duplex collecting system (DCS) is a relatively uncommon presentation with unclear management guidelines. Herein, we retrospectively reviewed all published cases of DCS with UTUC aiming to suggest personalized clinical care options for future cases. We conducted a systematic search for all cases of UTUC in DCS from published literature using the following keywords: UTUC, urothelial carcinoma (UC), collecting duct carcinoma, and DCS. The cases were summarized based on demographics, clinical presentation, predisposing risk factors, tumor location, management, and follow-up. We present an additional case based on our experience with a 69-year-old female with high-grade (HG) UTUC of the upper moiety in complete DCS. The patient underwent a robotic upper pole hemi-nephroureterectomy (hemi-NU) with a common sheath distal ureterectomy and a bladder cuff, followed by lower pole ureteral reimplantation. Overall, 34 patients with 35 renal units of UTUC in DCS were included and analyzed. To conclude, UTUC of DCS is rare and underreported. Hence, it is difficult to define a standard treatment. Although hemi-NU has been previously described, to the best of our knowledge, this is the first case report of robot-assisted hemi-NU for complete DCS with single-moiety UC.

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Prenatal imaging features and postnatal outcomes of isolated fetal duplex renal collecting system: A systematic review and meta‐analysis

Cited by 6 publications

References 35 publications

Fetal Renal Duplicated Collecting System at 14–16 Weeks of Gestation

Fetal Renal Duplicated Collecting System at 14–16 Weeks of Gestation

Evaluation of Pediatric Patients with a Diagnosis of Ureterocele

Management of Upper Tract Urothelial Carcinoma in a Double Collecting System Kidney

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