Duplex Kidney and Ureteral Duplications Associated Congenital Anomalies and Complications
Introduction: Congenital anomaly of the upper urinary tract is common anomaly in the superior urinary tract. It is more often asymptomatic. However, can associate with other anomalies and resulted in high morbidity in adults. The early detection of the anomalies is helpful to avoid complications and preserve renal function. The objective of the study is to describe the associated congenital anomalies, complications and treatment in two Private Hospitals.
Methods: A descriptive study was carried out on adult patients with duplex renal and ureteral system in two Private Hospitals in Aden Governorate during the period May 2012 to November 2018. Records of adult patients with unspecific clinical manifestations were assessed. Diagnosis was carried out with ultrasound, contrasted urography and computerized tomography describing the associated anomalies, complications, and treatment.
Result: Ninety patients were included; 46% males and 54% females with ages ranged from 16 to 61 years (mean age = 33 years). Associated anomalies were found in 33% of patients. The most common anomalies were adult dominant polycystic kidneys (63.3%) and ureteroceles (23%). Complications occurred in 40% of patients. Of them, 64% of patients had urinary tract infections (UTIs), 14% stones, 14% ureteroureteral reflux, 8% non-functional moiety and 3% transitional cell carcinoma in left lower pole of incomplete ureteral duplication. Renal function was normal in 74%, delayed in 22% and non-functional renal moieties in 4% of patients. Medical treatment was carried out in 75.6% and surgical intervened in 24.4% of patients
Conclusion: The most frequent complications were recurrent UTIs. The commonest associated anomaly was adult dominant polycystic kidneys. Computerized tomography is the effective imaging study, followed by contrasted urography. Medical treatment is the commonest type of treatment.
Keywords: Adults, Duplex System, Complications, Aden.