Quadruplication of the ureter in combination with a large ureteral cyst

Incomplete ureteral quintuplication obstructed by proximal calculus: Case report and review of literature

INTRODUCTION

Ureteral duplication is a common congenital anomaly, although multiple ureters is a rare disorder. Bifid ureter or multiple ureters are diagnosed incidentally and generally associated with obstruction by lithiasis.

CASE PRESENTATION

We present a case of ureteral quintuplication converging into a sacculation obstructed by a 7 cm calculus.

CONCLUSION

Two or more ureters are more common in women and it is mostly associated with asymptomatic presentation, excepting when related to complications of urinary tract infection or lithiasis. More than four ureters are extremely rare and our case is the first of incomplete quintuplication found so far in the literature.

Presentation and Diagnosis of Ureteral Quadruplication: Case Report and Analysis of the Literature

Ureteral quadruplication is exceedingly rare. All except for 2 cases were symptomatic and nearly all underwent intervention. We present the first case of asymptomatic ureteral quadruplication in the presence of ureteral cyst. The report is first to prove ureteral quadruplication, even with ureteral cyst, can have normal renal function and parenchyma without obstruction or reflux. The report analyzes differences between the 14 cases of ureteral quadruplication in the English literature. It is first to describe bilateral ureteral cysts with ureteral quadruplication and triplication, and is first to accurately characterize the appearance of quadruplicated ureters inside the kidney.

Ureteral quintuplication with renal atrophy in an infant after the 1986 Chernobyl nuclear disaster

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 English-language 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.

Preoperative diagnosis of congenital segmental giant megaureter presenting as a fetal abdominal mass

We describe a case of congenital segmental giant megaureter in a boy that presented as a fetal abdominal mass. He also had bilateral undescended testes, bilateral vesicoureteral reflux, and segmental aniridia. He presented with hypoglycemia in the neonatal period that resolved. Postnatal magnetic resonance imaging, voiding cystourethrography and radionuclide imaging established the diagnosis, and a ureteroureterostomy was performed at 12 months.

Quadruplication of dystopic kidney in combination with ureteral cyst

A case of ureteral quadruplication associated with renal dystopia is described. Four ureters drained into ureteric cyst and distal monoureter opened into the bladder. The literature concerned this extremely rare malformation is reviewed.

Case Report: Ureteral Quadruplication Associated with Ureteral Cyst and Massive Vesicoureteral Reflux Treated by Laparoscopic Nephroureterectomy

BACKGROUND AND PURPOSE

Ureteral quadruplication is an extremely unusual developmental abnormality. We present the eighth reported case but the first to be associated with a ureteral cyst, with massive vesicoureteral reflux that was treated with laparoscopic nephroureterectomy.

CASE REPORT

A 3-year-old boy was evaluated for recurrent urinary-tract infection. Massive left-sided vesicoureteral reflux associated with incomplete ureteral triplication was identified. A DMSA scan disclosed impaired function of this kidney. An uneventful total laparoscopic nephroureterectomy was performed at which a fourth atresic ureter was identified. All the four proximal ureters opened into a large ureteral cyst, and a distal monoureter opened into the bladder.

CONCLUSION

The patient recovered fully and was asymptomatic 6 months postoperatively.