Ureteric Duplication Anomalies

Duplex kidneys are mostly asymptomatic but they can be associated with significant pathology, often with long-term morbidity. The most common complications of duplex kidneys are vesicoureteral reflux (VUR), ureterocele, or ectopic ureter opening. VUR classically involves the lower pole ureter and tends to be of higher grade compared to a single system reflux. Obstruction of the upper pole may be due to ureteroceles in 80% of cases, although it may also occur secondary to an ectopic insertion. These patients usually present with urinary tract infections. Ultrasound is the most common imaging modality for the early detection of these complications. When detected antenatally, it is vital to follow-up these children over a period of time, to identify and treat the minority who develop symptoms. Surgical interventions aim to establish adequate drainage and avoid further renal damage.