Duplicated and ectopic ureter radiology

Duplication of collecting system is most common congenital urinary tract anomaly
; Spectrum from bifid renal pelvis to complete duplication (Incomplete : complete = 2:1)

Ectopic ureter
– Ureteral orifice below normal insertion in trigone; commonly associated with duplex collecting system

Duplicated ureter
– 2 ureters drain duplex kidney and remain separate down to bladder insertion or beyond

Upper moiety
– Inferomedial ectopic insertion (Weigert-Meyer rule)
– Ectopic ureterocele
– Obstruct

Lower moiety
– Inserted in trigone (orthotopic)
– Reflux (due to maldevelopment of valve mechanism)

Ectopic ureterocele
– Ectopic insertion of upper moiety ureter with accompanied ureterocele
– Causing obstruction

Intravenous Pyelogram (IVP)
– Drooping lily (lower pole compressed by dilated upper moiety)
– Nubbin sign (severe scarring in lower pole due to reflux)
– Yo-yo phenomenon (incomplete duplication with distal obstruction)

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