A case report of ureteroureterostomy for a complete duplex system of the kidney with an ectopic ureter

Abstract

Duplex anomalies are common and more frequently recognised in females. Presentation depends on the exact anatomical configuration of the abnormality. The anomalies can be associated with ectopic ureters, ureteroceles, obstruction, vesicoureteral reflux (VUR), urinary tract infections (UTIs), incontinence, and varying degrees of renal function loss.^1,2 There are multiple surgical approaches to correct these disorders when sequelae are sufficient to warrant intervention. There is, however, limited high-quality evidence to justify a certain approach over another. Traditional opinion has favoured an upper pole nephrectomy (UPN) for an upper moiety with poor function.²

There have been several studies highlighting the benefit of an ipsilateral ureteroureterostomy (IUU) as an alternative to the more invasive UPN, but little has been shown with regards to this presentation in an adult setting, or indeed high quality radiographic follow-up.^2-4

In this case report, an IUU for a young adult, with a delayed presentation, was performed. The patient had a complete duplication of her renal collecting system and a poorly functioning upper moiety, in which IUU proved to be a suitable intervention. Radiographic follow-up allowed accurate interpretation of the postoperative changes.

IUU is a viable option to treat anomalies associated with a duplex renal collecting system, which can be done safely with an acceptably low morbidity rate and higher renal function preservation rate as compared to UPN.