[Pathogen complete ureteric duplication in children. A 20 cases report]

ABSTRACT

Duplex System is a relatively rare malformative uropathy. It represents 0.2% of general population, with 15 to 25% of pathogen forms. A retrospective study of 20 cases, reported in 12 years is presented. Patient's age at diagnosis varied between 10 days and 10 years [mean age 47.5 months]. Feminine predominance was noted, with a sex-ratio of 0.42. Clinical features were dominated by urinary infection [65% of cases]. Antenatal diagnosis represented 25% of cases. Diagnosis was confirmed by ultrasound, intravenous urography, cystography and cystoscopy. We noted a vesico-ureteral ref lux in the lower pole in 15 cases, 9 ureteroceles and two ectopic ureteral implantation. Conservative treatment was endoscopic in 5 cases of vesico-ureteral reflux and surgical [reimplantation +/- ureterocele excision] in 10 patients. An upper pole nephrectomy was done in 8 cases and a lower pole nephrectomy in 1 case. Outcome was uneventful in all cases. Ureteric duplication is complex with prognosis depending essentially on early diagnosis and the degree of renal parenchyma damage