Complete Ureteral Duplication 4 (Differential Diagnosis as before)

harn_25a_n.jpg: Endoscopic picture of a 10.6-year-old boy with recurrent UTI. Notice in the center of the picture the colliculus. In addition, a funnel-shaped opening is visible in the back of the urethra and on the right side. It has a border ridge at the periphery. A ureter catheter has been introduced. harn_25b_n.jpg: VCUG of an analogous case: On the left side the filled, inconspicuous bladder is visible. On the right side, a retrograde filling of a left kidney with dilated calices during voiding; the corresponding ureter enters the urethra below the bladder. harn_25a_n.jpg and harn_25b_n.jpg: Both cases are examples of ureters with ectopic orifice; in figure harn_25a_n.jpg the orifice of the cranial ureter of a ureteral duplication lies in the urethra posterior and in figure harn_25b_n.jpg the orifice of a single ureter lies in the bladder neck. In both cases incontinence is present besides normal micturations. The pathological right renal part and the left kidney have suffered a damage due to the reflux; depending on the precise site and morphology of the orifice, instead of reflux a permanent or intermittent obstruction may cause renal damage, such as in an orifice within the bladder neck by the bladder sphincters, or by a ureterocele.