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CASE REPORT
Year : 2001  |  Volume : 18  |  Issue : 1  |  Page : 73-75
 

Inverted Y ureteral duplication


Department of Urology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow., India

Correspondence Address:
Anant Kumar
Department of Urology, SGPGIMS, Lucknow - 226014
India
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Source of Support: None, Conflict of Interest: None


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Keywords: Ureteric Anomaly; Inverted Y Duplication.


How to cite this article:
Zaman W, Singh V, Srivastava A, Kumar A. Inverted Y ureteral duplication. Indian J Urol 2001;18:73-5

How to cite this URL:
Zaman W, Singh V, Srivastava A, Kumar A. Inverted Y ureteral duplication. Indian J Urol [serial online] 2001 [cited 2019 Dec 8];18:73-5. Available from: http://www.indianjurol.com/text.asp?2001/18/1/73/37457



   Introduction Top


Inverted Y ureter is the rarest of the ureteric duplications.[1],[2] We report on a male child who had inverted Y duplication of the ureter with both segments opening into the single orifice, which has not been described previously. Various types, their embryology and indications for the management was discussed.


   Case Report Top


A 6-year-old male child presented with a history of left loin pain, dysuria and recurrent episodes of fever with chills for 3 months. Physical examination revealed tenderness in the left loin. Urine culture yielded growth of Pseudomonas aeroginosa. Blood chemistry was normal. Ultrasound of the kidneys showed left-sided gross hydronephrosis. a DMSA nuclear scan of the small contracted left kidney with poor parenchymal function while right kidney was normal. DTPA renal scan showed GFR of 18.2 ml/min and 70.1 ml/min in left and right kidney respectively. Voiding cystourethrogram demonstrated left sided grade IV reflux with duplication of lower ureter. Cystoscopy revealed that left ureteric orifice was patulous with both ureteric segments opening inside the common orifice. Common sheath reimplantation done by Politano-Leadbetter technique and both the ureters were splinted. On 10th postoperative day splintogram was done that confirmed inverted Y ureteral duplication. On followup, child was asymptomatic and cystogram revealed no vesicoureteric reflux.


   Comment Top


Inverted Y duplication of the ureter is believed to be the most rare of all branching anomalies of the ureter. Embryologically, ureteral duplication has been explained as the result of fusion of a single ureteral bud or double budding from the mesonephric duct.[1],[2] We report on a male child who had inverted Y duplication of the ureter with both the segments opening into the single orifice, which has not been described previously. A single ureteric bud could have caused the anomaly described after it had begun to migrate and then rejoining before entering into the metanephric blastema.

In the absence of concomitant lesion, such as a ureterocele, reflux or paraureteral diverticulum, no treatment is required. Treatment is advised if the duplicated segment is thought to be the cause of symptoms.[3]

 
   References Top

1.Mosli HA. Schillinger JF, Futter N. Inverted Y duplication of the ureter. J Urol 1986: 135: 126-127.  Back to cited text no. 1    
2.Bingham BJG. Duplicate segment within a single meter. J Urol 1986: 135: 1234.  Back to cited text no. 2    
3.Regan TC. Dejter SW Jr. Inverted Y duplication of the ureter with associated ureterocele and bladder outlet obstruction. J Urol 1996: 155:642.  Back to cited text no. 3    




 

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    Introduction
    Case Report
    Comment
    References

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