Interestingly, and explaining the Weigert-Meyer rule, the future lower pole ureter separates from Wolffian duct earlier and thus migrates superiorly and laterally as the urogenital sinus grows.ĭuplication can be variable. At one end of the spectrum, there is merely a duplication of the renal pelvis, draining via a single ureter. PathologyĮmbryologically, duplication occurs when two separate ureteric buds arise from a single Wolffian duct. Occasionally, hydronephrosis can be severe enough to result in flank discomfort or even a palpable mass. However, where symptoms do occur (infection, reflux or obstruction), the patient is likely to have completely duplicated ureters.
Most duplicated systems are asymptomatic and diagnosed incidentally. Duplex collecting systems are seen in 0.7% of the healthy adult population and 2-4% of patients investigated for urinary tract symptoms 7.
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