A Case Report of Ureteral Triplication with Contralateral Duplication-A Rare Anomaly with Difficult Diagnosis and Treatment

Abstract

Ureteral triplication is a rare congenital anomaly of the urinary tract with around 100 reported cases in English literature. Rarer is the presence of bilateral ectopic ureter with it. Here, a case of a young female patient who presented with continuous incontinence and right loin pain is reported. On thorough investigation she was found to have trifurcate right renal pelvis with right triple ureter forming single dilated right lower ureter, which was opening ectopically into vaginal vault; associated with hydronephrosis on right side. There was duplex moiety of left kidney with hydronephrosis of upper moiety with ectopic opening of upper ureter into vaginal vault. She was treated with laparoscopic right ureteric reimplantation with successful recovery. Multifarious presentations sometimes make it difficult to identify clinically and diagnose on imaging findings. The presentation of ureteral triplication and the features on diagnostic modalities like ureteroscopy, retrograde pyelography and magnetic resonance urography are hereby discussed with review of literature.

Keywords

• hydronephrosis
• magnetic resonance urography
• retrograde pyelography
• wolffian ducts