Ureteral Duplications (UTI/VUR)

Figure harn_18a_n.jpg to harn_18d_n.jpg: Drawings of the incomplete and complete types of ureteral duplications. Figure harn_18a_n.jpg and harn_18b_n.jpg: Incomplete ureteral duplications in which there is a common distal ureter. Figure harn_18a_n.jpg: The common distal ureter is long. Figure harn_18b_n.jpg: The common distal ureter is short. In incomplete ureteral duplications other terms exist, such as ureter bifidus and Y-type (if the common ureter is long), or V-type (if the common ureter is short). harn_18c_n.jpg and harn_18d_n.jpg: Complete ureteral duplications in which two ureters enter the bladder (= ureter duplex), or one of them has an ectopic orifice outside the bladder. harn_18c_n.jpg: Both ureters enter the bladder separately. harn_18d_n.jpg: The ureter of the lower pole enters the bladder, and the ureter of the upper pole enters distally to the trigonum in the urethra or outside of it. In harn_18c_n.jpg the ureter of the lower pole enters the bladder cranially, and the ureter of the upper pole enters the bladder caudally in the trigonum. In harn_18d_n.jpg: the ureter of the lower pole enters the bladder normally while the ureter of the upper pole enters the bladder neck, the urethra, or the seminal vesicle or the vulva. In complete duplication of the ureter the ureter of the upper pole may exhibit a ureterocele independently of the site of the orifice, either in the bladder, bladder neck, or urethra without or with reflux. The multiplicity of the anatomical types of ureteral duplication explains the large number of different symptoms and signs; all have in common the possibility of urinary tract infection.