Anatomy of the Incomplete Ureteral Duplication

Ureteral duplications constitute the most common congenital anomalies of the urinary tract. Incomplete duplications are associated with uretero‐uremic reflex or uretero‐pelvic junction obstruction. Here we report an incomplete duplication of the left ureter observed in a 75 year old male cadaver. The medial ureter emerged from the upper end of the hilum, passed posterior to renal, gonadal and left colic vessels and fused with the lateral ureter halfway on the lateral pelvic wall. The lateral ureter emerged from the lower hilum, crossed the psoas, approached the medial one at the left common iliac artery level, both crossed the internal iliac artery, united with each other, crossed the vas, turned medially and dumped into the bladder. Throughout their course, the ureters were retroperitoneal. The common ureter was almost twice as thick as the duplicated segments. Duplicated segments were accompanied by a rich vascular network. A Y‐shaped vein with one arm coming from the renal vein and the other from the lower pole of the kidney connected to the left gonadal vein. The left colic vein dumped into the left gonadal vein. There were two testicular arteries ‐ one from the renal and the other from the aorta. Renal artery divided precociously adjacent to the aorta and behind the renal vein. The right kidney and ureter were normal. Right gonadal vein dumped into right renal close to its union with the inferior vena cava. The cause of anomalous vascular connection of the left gonadal vein associated with ureteral duplication is not known. Grant Funding Source : Mercer University