Duplicated collecting system overview

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Duplicated collecting system is the most common upper urinary tract anomaly, affecting nearly 15% of the population. [1] [2] [3]

Embryologically occurs when 2 separate ureteric buds arise from a single wolffian duct. The future lower pole ureter separates from Wolffian duct earlier and migrates superiorly and laterally as the urogenital sinus grows.

Weigert-Meyer rule for bladder insertion: the upper pole ureter inserts inferior and medial to lower ureter.

Alternatively, the 2 ureters may fuse to form a single ureter prior to inserting into the bladder, termed a bifid system.

The lower pole system is usually dominant, while the upper system may drain a single or few calices.

The upper pole ureter may demonstrate a ureterocele, which is associated with ureteral obstruction and recurrent UTIs in children. The upper pole ureter may also be ectopic or stenotic.

References

  1. Glassberg KI, et al. Suggested terminology for duplex systems, ectopic ureters and ureteroceles. J Urol 1984; 132(6):1153-4.
  2. Callahan MJ. The drooping lily sign. Radiology. 2001 Apr;219(1):226-8.
  3. Sheth S and Fishman E. Multi-detector row CT of the kidneys and urinary tract: techniques and applications in the diagnosis of benign diseases. RadioGraphics 2004;24:e20.

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