Diagnosis and treatment of duplication of the renal pelvis and ureter / 中国医师进修杂志

ABSTRACT

Objective To evaluate the diagnosis and treatment of duplication of the renal pelvis and ureter. Methods The clinical data of 9 patients with duplication of the renal pelvis and ureter who were treated from May 2014 to January 2018 in the Second People′s Hospital of Lianyungang were retrospectively analyzed. Of the 9 cases, 1 case was male, and 8 cases were female. The age range from 6 to 68(40.4 ± 20.6) years. Three cases of duplex kidneys were on the left side, 4 cases on the right side, and 2 cases on the both side. 6 cases had imcomplete duplex systems and 3 cases had complete duplex systems. The diagnosis rate of ultrasound, intravenous urography (IVU), CT scan, magnetic resonance urography (MRU), retrograde pyelography (RPG) was 3/9, 7/8, 5/9, 0/1 and 2/2 respectively. Results One case with simple urinary tract infection was cured by antimicrobial agents, and 1 case with lower ureteral calculus was cured by lithagogue drugs. One case with renal calculus and pyonephrosis in upper moiety of duplex kidney underwent retroperitoneoscopic nephrectomy, 1 case with ureteropelvic junction obstruction and horseshoe kidney underwent division of the isthmus and pyeloplasty, and 2 cases with ureterocele underwent transurethral incision. The clinical symptoms of patients who underwent surgery were cured in all cases. Three cases without complications underwent conservative treatment, and follow-up observation showed no complications. Conclusions Duplication of the renal pelvis and ureter can be diagnosed properly based on imaging data. IVU has a significant advantage, while RPG has high specificity in difficult cases. Treatment should be individualized according to clinical symptoms, complications and other urinary tract congenital anomaly.