A surgical procedure suggested for certain cases of reduplicated ureter

Ureteroureteric reflux. Pathological entity or physiological phenomenon?

The clinical, urographic and radionuclide examinations of 28 consecutive patients with incomplete duplication of the upper urinary tract are presented. Four possible types of urodynamic abnormality can occur in this condition and 3 of these were found in 8 of the 28 patients. The urodynamics of normal and duplex upper tracts are reviewed and the question of whether the abnormalities represent a pathological process requiring surgery or a harmless physiological variant is examined.

Ureteric diverticula: ureterodiverticular reflux and yo-yo effect. A television study with spot filming

Two cases of ureteric diverticulum are presented. Repeated infective episodes were the main presenting features in one, whereas intermittent attacks of colicky pain brought the other patient in for clinical assessment. Fluoroscopic evaluation of the latter patient demonstrated free ureterodiverticular reflux and yo-yo phenomenon. Following diverticulectomy the pain completely disappeared.

Yo-yo renal pelvis: an unusual cause of flank pain

Herein we describe 2 patients in whom a bifid renal pelvis was associated with peristaltic dysfunction and pyelopelvic reflux, causing pyelocaliectasis and flank pain. The patients were improved with pyelopyelostomy. Previous explanations for the yo-yo phenomenon have indicated that there is functional obstruction because of a higher resting pressure in the common stem. The asynchronous peristaltic waves a coincident with a relatively low pressure in the oal fold that acted as a baffle to direct the flow of urine from the lower segment of the bifid pelvis down the ureter. This baffle favored reflux into the upper segment.

[Anastomoses of the urinary tract for treatment of duplicated ureters (author's transl)]

Anastomoses between the kidney pelves or the ureters are excellent operative procedures to correct duplications of the urinary tract in distinct cases. Heminephrectomy may be avoided, when only one of the ureters is affected and the parenchyma of both portions of the kidney is intact. Indications are megalureter, recurrent refluxes, ureteroceles and ectopic ureteral orifice. The operative technic used in 13 cases is described. Advantages and disadvantages are discussed.