Abstract

Objective: Complete duplication of the upper urinary tract is a very rare complex anomaly. There is no standard option about the treatment of these patients especially in cases accompanied by ureterocele. In our study, we aimed to discuss the indications for surgery with upper urinary tract duplications, the results and the treatment options of 24 cases in the light of literature.

Methods: Between 2005-2011, 24 cases which were operated for the upper urinary tract duplications were analyzed retrospectively. Clinical findings and test results were examined and the surgical interventions were decided.

Results: The ages ranged from 5 days to 14 years with a mean of 4,88±3,83 years and twenty-four patients of five males and nineteen females were evaluated from hospital records retrospectively. In twelwe cases the duplicated urinary tract was on the left; in ten cases on the right and in two cases it was bilateral. Endoscopic ureterocele incision was performed in three of the five cases which were associated with a ureterocele. In six cases, ureteroneocystostomy was performed due to high grade vesicoureteral reflux. Initially endoscopic subureteric injection was applied to ten patients. Eleven of the fourteen cases were treated by common sheath ureteroneocystostomy while in three cases, ureteroneocystostomy with excision of the dilated ureter was performed after ureteroureterostomy.

Conclusion: Upper urinary tract duplications are very rare complex anomalies. It is important to determine the specific treatment options because many different surgical procedures from heminephrectomy to endoscopic ureterocele incision may be needed. Heminephrectomy is a treatment option for the cases without reflux to normal renal unit. Patients with lower pole reflux should be evaluated as the patients with single system of reflux. We think that there is no contribution of early endoscopic incision of ureterocele on the conservation of the upper pole functions and in the prevention of recurrent urinary tract infections.