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Purpose: To study the prevalence of duplex system and double ureter in cadavers and intravenous pyelograms in Indian population.
Materials and Methods: Fifty cadavers were dissected and 50 intravenous pyelograms were examined on both (right and left) sides for the presence of duplex system and double ureter.
Results: One male cadaver aged 43 years showed complete double ureter and duplex system on the right side and incomplete double ureter and duplex system on the left side. Another male cadaver aged 56 years showed incomplete double ureter and duplex system only on the right side. An intravenous pyelogram of a 43-year-old man showed incomplete double ureter along with duplex system on the right side.
Conclusion: Developmental anomalies of the kidney, ureter, and urinary bladder should be kept in mind and promptly detected before the manifestations of aforementioned complications increase the morbidity of the affected individuals.
Keywords: ureter, cadaver, anatomy, dissection
Urol J. 2011;8:145-8.
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INTRODUCTION
Underlying embryological basis can be explained as development of two ureteral buds separately from a single mesonephric duct give rise to a duplex kidney with complete ureteral duplication. On the other hand, bifurcation of a single ureteral bud proximal to the ampulla (distal dilated part) gives rise to a duplex kidney with a bifid pelvis or ureter.(1) Double ureter, with the prevalence of 0.1% to 3%,(2,3) has been reported by various authors.(1,4-8)
Duplex system is explained as the kidney with two pyelocaliceal systems, which may have either single or bifid ureter (partial duplication) or double ureter draining separately into the urinary bladder (complete duplication), with a single renal parenchyma that is drained by two pyelocaliceal systems.(9)
Double ureter and duplex system reported in the literature time and again have potential for future complications, such as the collecting system obstruction, lithiasis, ureterocele, and vesicoureteral reflux.(10-16) Hence, their early detection may be helpful in better management and increased survival rates.
Lee and colleagues through three-dimensional reconstructed computed tomography urography demonstrated that duplicated ureters on the right side joined at the upper proximal part of the ureter and duplicated ureters on the left side put together just above the ureterovesical junction.(17) Sun and associates presented one case of blindending bifid ureter originating from the middle third of the ureter.(18) Hascalek and coworkers...