Vol. 116, December Printed in U.S.A.

THE JOURNAL OF UROLOGY

Copyright © 1976 by The Williams & Wilkins Co.

TRIPLICATE URETER WITH CONTRALATERAL URETERAL DUPLICATION JOHN F. REDMAN From the Department of Urology, University of Arkansas College of Medicine, Little Rock, Arkansas

ABSTRACT

A case involving a triplicate ureter on 1 side and a contralateral duplicate ureter is reported. The occurrence of 5 ureters in a single patient is a urologic curiosity. This anomaly has been reported on 3 previous occasions. 1 · 3 A patient with ureteral triplication and contralateral ureteral duplication is described. CASE REPORT

S. B., a 24-year-old black man, was evaluated for an elective circumcision. In a review of the case record it was noted that an excretory urogram (IVP) had been obtained previously and had demonstrated ureteral triplication and contralateral ureteral duplication (see figure). The IVP had been done for reasons that were unknown, since the patient denied any genitourinary symptoms. From the records available it appeared that the examination was obtained during the course of an evaluation of gastrointestinal complaints. DISCUSSION

The patient described represents a chance discovery of 5 ureters. Ureteral triplications were classified by Smith in 1946. 4 He listed 4 types: 1) triple ureter-a complete triple ureter with 3 separate orifices either opening into the bladder or ectopically, 2) double ureter with 1 bifid-2 ureters may unite, leaving only 2 orifices, 3) trifid ureter-all 3 ureters may unite and drain through a single orifice and 4) double ureter with inversion Y bifurcation-2 ureters arise from a kidney with a bifurcation of one of them before it reaches the bladder. Although Smith described a double ureter with 1 bifid he personally could find no record of such an occurrence. Several other cases of this type of triplication have been reported subsequently. 2 The case herein reported probably represents Smith's second type of triplication in which 2 ureters join, allowing 2 ureters to continue to the bladder.

Accepted for publication May 28, 1976.

REFERENCES

1. Burt, J. C., Lane, C. M. and Hamilton, J. L.: An unusual anomaly of the upper urinary tract. J. Urol., 46: 235, 1941. 2. Peterson, C., Jr. and Silbiger, M. L.: Five ureters: a case report. J. Urol., 100: 160, 1968. 3. Wolpowitz, A., Evan, P. and Botha, P.A. G.: Triplication of ureter on one side and duplication on the other. Brit. J. Urol., 47: 622, 1975. 4. Smith, I.: Triplicate ureter. Brit. J. Surg., 34: 182, 1946.

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Triplicate ureter with contralateral ureteral duplication.

Vol. 116, December Printed in U.S.A. THE JOURNAL OF UROLOGY Copyright © 1976 by The Williams & Wilkins Co. TRIPLICATE URETER WITH CONTRALATERAL URE...
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