Ureteral duplication

Ureteral duplication

Duplication of the ureter ( Figure 82.3 ) and renal pelvis is a common anomaly , with an incidence of approximately 1 in 150 births. Unilateral duplication is six times more common than bilateral. It is more common in females. The duplication may be incomplete (Y-shaped ureter) or complete. It is associ ated with vesicoureteric reflux (VUR), PUJO and ureterocele. Incomplete duplex ureters with a ‘Y’ ureter arise when the ureteric bud bifurcates after its initial development from the Wol ffi an duct. Complete ureteric duplication occurs when there are two separate ureteric buds that develop into two sepa rate ureters, which drain the upper and lower kidney moieties separately . The lower moiety ureter has a shorter submucosal tunnel and is prone to VUR. PUJO is more common with the often associated with a concomitant ureterocele. The upper moiety of the kidney is often dysplastic.