Duplex Kidney Anomalies and Associated Pathologies in Children: A Single-Center Retrospective Review

Abstract

Introduction: Duplex renal collecting systems are one of the most common congenital anomalies of the urinary tract. The exact prevalence of this anomaly is difficult to ascertain because most patients are asymptomatic, and the abnormality is frequently detected incidentally. The aim of this study is to retrospectively review the demographic characteristics and different clinical presentations, related pathology, and treatment methods of patients with duplex system anomaly who applied to our institution, with a literature review.

Methods: This is a retrospective study, performed at the Department of Pediatric Urology and Pediatric Surgery, Umraniye Training and Research Hospital, a tertiary center, from 2010 to 2021. Age, gender, presenting symptoms, and associated anomalies were determined in all patients. Asymptomatic patients with variants of duplex kidney anomaly detected incidentally did not require any surgical intervention. Necessary surgical interventions were performed depending on the pathologies of other symptomatic patients associated with duplex kidney anomaly variants.

Results: A total of 239 patients had duplex systems. The patients were divided into two groups according to their age, 0-24 months (newborn and infant) and over 24 months. There were 45 (18.8%) patients in the 1st group and 194 (81.1%) patients in the 2nd group. It was seen that the most common symptom in 85 (35.6%) patients was urinary tract infection (UTI). It was observed that 5 (2%) patients had no symptoms and were detected during routine screening. When comorbidities detected with the duplex system were examined, the most common ones were antenatal hydronephrosis 23 (9.6%). Ureterocele excision was performed in ten patients, laparoscopic heminephrectomy was performed in six patients, and ureteroneocystostomy was performed in one patient.

Conclusions: It is important that magnetic resonance urography (MRU) duplex renal collecting systems, which is a current imaging method used in the evaluation of the duplex system, provide detailed information about the morphology and function and are useful in the evaluation of associated anomalies. Diagnosis and treatment before it becomes symptomatic or results in further kidney damage are important for the preservation of renal function in advanced follow-ups.

Keywords: bifid pelvis; dupleks kidney; hydronephrosis; ureteral duplication; ureterocele.

Figure 1. Comorbidities associated with the duplex renal system