ABSTRACT
The anatomic sequelae of ureteral duplication include partial duplication, ectopic ureter, ureterocele, and vesicoureteric reflux. Treatment, when indicated, is primarily surgical and is aimed at preservation of renal function, minimizing morbidity from urinary tract infection, correction of urinary incontinence, and relief of symptoms associated with urinary obstruction. Various classification systems have been proposed based on the location of the ureteral opening, characteristics of the orifice, or association with single or duplex collecting systems. Voiding cystourethrography is the study of choice to detect and characterize VUR. Upper-pole ureters that are obstructed by small intravesical ureteroceles may also be managed with ureteroureterostomy, however large ureteroceles or ectopic ureteroceles frequently require an intravesical operation for formal ureterocele excision and bladder floor reconstruction. Common secondary operations include ureteral reimplantation, excision of the ureteral stump, and ureterocele excision. An upper-to-lower pyelopyelostomy or ureteropyelostomy can be considered when there is upper-pole ureteral obstruction secondary to an ectopic ureter or ureterocele.
