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
- ↑ Glassberg KI, et al. Suggested terminology for duplex systems, ectopic ureters and ureteroceles. J Urol 1984; 132(6):1153-4.
- ↑ Callahan MJ. The drooping lily sign. Radiology. 2001 Apr;219(1):226-8.
- ↑ 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.