{"paper_id":"8034e1f6-793d-4865-973d-212d6cc9d719","body_text":"ew\nAnnals of Minimally Invasive Surgeries\nOpen Access | Page 41 |\nVol 4 | Issue 1 | Pages 41-43\nISSN: 2689-8764\nCopyright: © 2022 Leal C. This is an open-access article distributed under the terms of the Creative \nCommons Attribution License, which permits unrestricted use, distribution, and reproduction in \nany medium, provided the original author and source are credited.\nSchOlArly  PAgeSSCHOLARS. DIRECT\nDOI: 10.36959/351/590\n“Duplex Ureter”: ¿Are we Aware of this Uncommon \nFinding?\nCarlos Leal, MD, PhD*\nDivision of Gynecologic Oncology, Department of Obstetrics and Gynecology, Universidad Autónoma de \nChihuahua, Mexico\nCase Report\nCheck for\nupdates\nbilateral or unilateral, and different defects often coexist in \nan individual patient [1].\nComplete or partial duplication of the renal collecting \nsystem also referred to as a duplicated system, is the \nmost common congenital anomaly of the urinary tract [2]. \nAutopsy studies report an estimated incidence of 0.8 to 5.0 \npercent [3]. Double collecting systems are thought to result \nfrom duplication of the ureteric bud, with the superior bud \nassociated with the upper renal pole, and the inferior bud \nwith the lower renal pole.\nIn complete duplication, the kidney has two separate \npelvicalyceal systems and two ureters. The ureter from the \nlower collecting system usually enters the bladder in the \ntrigone, whereas the ureter from the upper collecting system \nA 27-year-old, gravida 0 para 0, female presented herself \nfor an evaluation of recurrent urinary tract infections and \nsevere dysmenorrhea. The ultrasound revealed a bilateral \nsmall but complex adnexal mass, suggesting endometriosis \n(Figure 1). Ca 125 was 88 U. Laparoscopic surgery was \nperformed, showing evidence of infiltrative endometriosis \nand entrapment of the right ureter on the right pelvic \nsidewall (Figure 2); During the initial anatomical inspection a \nduplicated ureter was diagnosed (Figure 3). The laparoscopic \nsurgery was performed to liberate both ureters and resection \nof the deep endometriosis without any complicated issues \n(Figure 4).\nCongenital anomalies of the kidney and the urinary tract \n(CAKUT) constitute approximately 20 to 30 percent of all \nanomalies identified in the prenatal period. Defects can be \n         \nFigure 1: US findings: Right ovary within the normal size but with a complex solid mass. Left ovary with complex mass with a solid \nlesion measured 3 cm. Doppler negative.\n\nCitation: Leal C (2022) “Duplex Ureter”: ¿Are we Aware of this Uncommon Finding?. Ann Minim Invasive Surg 4(1):41-43\nleal. Ann Minim Invasive Surg 2022, 4(1):41-43\nOpen Access | Page 42 |\ncan have a normal insertion in the trigone, or it can be inserted \nectopically in the bladder or elsewhere. Ectopic insertion of \nthe ureter can result in obstruction or vesicoureteral reflux \n(VUR) [4]. Depending on the location of the ectopic insertion, \nincontinence also may be present.\nPartial duplication is more common than complete \nduplication. In these cases, the kidney has two separate \npelvicalyceal systems, with either a single ureter or two \nureters that unite prior to insertion into the bladder. Strong \nknowledge of the retroperitoneal anatomy will facilitate the \nureteral findings [5].\nIn patients with asymptomatic uncomplicated (no dilation) \n*Corresponding author: Carlos Leal, MD, PhD, Division of Gy -\nnecologic Oncology, Department of Obstetrics and Gynecology, \nUniversidad Autónoma de Chihuahua, Calle de La Llave #1419 \nsuite 103 Colonia Centro, CP 31000, Mexico, Tel: +52-(614)-\n2353022\nAccepted: January 29, 2022\nPublished online: January 31, 2022\nCitation: Leal C (2022) “Duplex Ureter”: ¿Are we Aware of this \nUncommon Finding?. Ann Minim Invasive Surg 4(1):41-43\n         \nFigure 2: Initial laparoscopic inspection, showing evidence of infiltrative endometriosis, mainly on the   right pelvic sidewall.\n         \nFigure 3: Laparoscopic view showing evidence of a duplex right ureter.\n\nCitation: Leal C (2022) “Duplex Ureter”: ¿Are we Aware of this Uncommon Finding?. Ann Minim Invasive Surg 4(1):41-43\nleal. Ann Minim Invasive Surg 2022, 4(1):41-43\nOpen Access | Page 43 |\n2. Williams H (2007) Renal revision: From lobulation to duplication-\n-what is normal? Arch Dis Child Educ Pract Ed 92: ep152-ep158.\n3. Decter RM (1997) Renal duplication and fusion anomalies. \nPediatr Clin North Am 44: 1323-1341.\n4. Glassberg KI (2002) Normal and abnormal development of the \nkidney: A clinician's interpretation of current knowledge. J Urol \n167: 2339-2350.\n5. Carlos L, Espinoza V, Valenzuela A, et al. (2020) The Bermuda \nTriangle’ a didactic description of the retroperitoneal anatomy. J \nMinim Invasive Gynecol 27: S118.\nduplication of the collecting system, no further intervention \nor referral is needed. However, if there is a history of urinary \ntract infection (UTI) or dilation (typically due to obstruction) \nfurther interventions must be done, this can be done with \nlaparoscopic surgery.\nReferences\n1. Queisser-Luft A, Stolz G, Wiesel A, et al. (2002) Malformations in \nnewborn: Results based on 30,940 infants and fetuses from the \nmainz congenital birth defect monitoring system (1990-1998). \nArch Gynecol Obstet 266: 163-167.\n         \nFigure 4: Retroperitoneal dissection of both right ureters; separating the retroperitoneal spaces and vessels anatomy.\nCopyright: © 2022 Leal C. This is an open-access article distributed under the terms of the Creative \nCommons Attribution License, which permits unrestricted use, distribution, and reproduction in \nany medium, provided the original author and source are credited.\nSCHOLARS. DIRECT\nDOI: 10.36959/351/590","source_license":"CC0","license_restricted":false}