Presentation
Recurrent urinary tract infections for the past year despite prophylactic techniques.
Patient Data
There are two ureters originating from bilateral both kidneys. On the right, the two ureters appear to join at the level of the sacrum. The conjoined ureters then insert ectopically at the medial and inferior aspect of the bladder. The two left ureters remain separate throughout their course. On the left, the ureter arising from the upper pole inserts ectopically on the medial and inferior bladder, whereas the ureter originating from the lower pole inserts lateral and more superior, Both medially inserted ureters are associated with a ureterocele.
Case Discussion
This is a case of bilateral duplicated ureters as seen on CT. For the majority of her life, she has been asymptomatic with no history of urologic complaints. Recently, the patient started to develop recurrent urinary tract infections despite prophylactic measures (prophylactic post-coital voiding, frequent voiding, hydration, and cranberry juice). Three-phase CT (renal mass protocol) demonstrated two distinct ureters on the left and two ureters on the right that join distally before entering the bladder.
Co-authors:
Peter Kim, MD
Christine Cooley, MD
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