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Information for Parents

Duplex Renal Systems

  • What is this disease?

    • Duplex kidney literally means that the child has a double kidney on one side or very rarely both sides. The double section is usually limited to the part of the kidney where the urine collects (the collecting system or renal pelvis), before the urine passes down the bladder via the ureter. However, in some cases there is also duplication of the ureter . This can be a partial duplication (so the ureter is a ‘Y’ shape) or there may be a completely separate extra ureter.The limited duplex kidney (where only the collecting system is double) is usually an incidental finding and rarely causes problems. The more extensive duplication, however, does often cause problems and can typically mean a child is more prone to urine infections. Also the extra ureter can insert into the bladder in an abnormal place or even in the urethra (the tube leading from the bladder to the outside), causing constant urinary dribbling.The duplicated part of the kidney drained by that ureter has often not developed normally (it is known as ‘dysplastic‘) and thus has poor function.

  • How it is diagnosed?

    • If not picked up in antenatal scans, these children are initially suspected to have Duplex system on USG done for Urinary tract infection. The diagnosis is confirmed by either IVP(done earlier) or MRU(MR Urography) or rarely CT urography. DMSA scan is done to check functioning of duplex system and DTPA scan is needed to check if there is any obstruction in system.

  •  How it is treated?

    • In incidentally diagnosed children with no hydronephrosis or Urinary tract infection, only close observation is needed. Hydronephrosis, UTI, dribbling of urine(ectopic ureter) or associated ureterocele are some of the indications of surgery

  • When it should be operated?

    • The decision to operate will depend upon clinical condition of child. However, early surgery is done if there is risk of infections and renal damage.

  • Are there other alternative methods of treatment?

    • Medical management in terms of continuous antibiotic prophylaxis (CAP) is done in few cases.

  • What all I need to know before my child surgery?

    • Read “All you need to know before your child's surgery” information booklet in website.

  • How is the surgery done?

    • The surgery will depend upon the anatomy, renal functioning and clinical condition of the child. It can incude cystoscopy( for ureterocele), pyeloplasty( if upper ureteric obstruction in functioning kidney), common sheath re implant ( if VUR), upper polar nephrectomy with ureterectomy( if kidney non functioning). These surgery can be done both by open and minimally invasive means (Laparoscopy)

  • Remarks

    • For more details of surgery, contact your surgeon

  • Related Photographs and videos

    • Few photographs and video of steps done by me  is given here for learning purposes

Dr Shandip Kumar Sinha

Pediatric Surgeon,Paediatric Urologist and Paediatric Laparoscopic Surgeon

Avaialble At:

Madhukar Rainbow Children Hospital, Malviya Nagar, Delhi,India

For appointment

contact or WhattaApp +919971336008

Email: consult@pediatricsurgery.in