Main Article Content


Ureteral quadruplication is a very rare developmental malformation and it is sometimes associated with other congenital urinary tract abnormalities. This is the first case described in our country and in Africa, and apparently the 13th worldwide. It concerns a 9 years old Black child of the male gender, with a history of distended and progressively painful abdomen. Six years ago, the patient was brought to the hospital for a painful abdominal mass associated with fever and cough. Fever and cough was finally found to belong to malaria and upper respiratory tract infection. In the CT-scan, the abdominal lump was reported to be a polycystic kidney in combination with ureterohydronephrosis. After a laparotomy indicated for this former condition, per operative diagnosis was that of a unilateral quadruplication of the right ureter, opened into a close proximal ureteral cyst. The distal monoureter opened into the bladder. Surgery of this malformation was conservative. It consisted of ureteral resection of its dilated proximal portion, and nephro-ureteral end to end anastomosis after ureteropyeloplasty. Post-operative outcome was marked by the fact that the child had clinically recovered from the previous symptoms and his paraclinic exams and laboratory tests were progressively satisfactory. In conclusion, in the presence of an abdominal mass associated with urinary tract signs in late childhood, the physician should also evoke ureteral malformation in his differential diagnosis. In terms of differential diagnosis, this case has a broad clinical impact across medicine because it is implicating both surgery (urology and pediatric surgery) and internal medicine (nephrology and medical oncology). In the other hand, renal conservative surgery is to be considered when the secretory function remains.


Ureter quadruplication ureteral cyst nephropyeloplasty vesico-ureteral reflux.

Article Details

Author Biographies

Désiré Akaba, University of Yaounde I

Department of Morphological sciences and Pathology. Assistant.

Joseph Marie Mendimi Nkodo, University of Yaounde I

Department of Morphological sciences and Pathology. Junior lecturer.

Pierre Joseph Fouda, University of Yaounde I

Department of Sugery and Anesthesiology. Junior lecturer

Jean Marie Bob'Oyono, University of Yaounde I

Department of Sugery and Anesthesiology. Senior lecturer
How to Cite
Akaba, D., Mendimi Nkodo, J. M., Fouda, P. J., & Bob’Oyono, J. M. (2013). Proximal Ureteral Quadruplication In Combination With Ureteral Cyst: a case report. HEALTH SCIENCES AND DISEASE, 14(1).


  1. Soderdahl DW, Shiraki IW, Schamber DT. Bilateral ureteral quadruplication. J Urol 1976, 116:255-6.
  2. Fawaz B, Vancells M, Rodó Salas J, Durán V. Ureteral multiplicity. Review of case records. An Esp Pediatr 1984, 6:609-14.
  3. Bolkier M, Moskovitz B, Ginesin Y, et al. Incomplete quadruplication of urinary tract with contra lateral agenesis of the kidney. Eur Urol 1991, 3: 267-8.
  4. Sourtzis S, Damry N, Janssen F, Perlmutter N. Ureteral quadruplication: the fourth case report. Pediatr Radiol 1994, 2:604-5.
  5. Klinge L, Kubiak R, Slongo T. Quadruplication of the ureter in combination with a large ureteral cyst. Pediatr Surg Int 2001, 17:566-8.
  6. Lopes RI, Lopes RN, Barbosa Filho CM. Ureteral quadruplication with contralateral triplicate ureter. J Urol 2001, 166:979-80.
  7. Moses KA, Scherz HC. Partial ureteral quadruplication with contralateral multicystic dysplastic kidney. Urology 2010, 76:461-2.
  8. Saxena V, Kumar R. Bilateral ureteric quadruplication with renal calculus. Urology 2011, 77:592-3.
  9. Vicentini FC, Denes FT, Srougi M. Case report: ureteral quadruplication associated with ureteral cyst and massive vesicoureteral reflux treated by laparoscopic nephroureterectomy. J Endourol 2007, 21:769-71.
  10. Koszutski T, Kudela G, Mikosiński M, Utrata W. Quadruplication of dystrophic kidney in combination with ureteral cyst. J Pediatr Surg 2008,43: 13-5.
  11. Metin A, Gürel S, Onol SY, Onol FF, Gücük A, Boran C, Dağistan E. Ureteral quadruplication with three blind-ending branches. Int Urol Nephrol 2013, 45: 69-71.

Most read articles by the same author(s)

1 2 > >>