Non Functioning Upper Moiety Of A Right Duplex Kidney
A 1 year old Girl from Indonesia was brought by her mother for further management of recurrent UTI. The child had had her first UTI at the age of 3 months. Investigations in Indonesia revealed that the child had a Duplex Right kidney with what appeared to be Hydronephrosis of the right upper Moiety. Further detailed investigations revealed that the Right Upper Moiety Ureter was also dilated and there was a large Ureterocoele in the bladder. A MAG3 revealed 10% function of the upper moiety. I decided to puncture the ureterocoele and allow drainage of the obstructed right upper moiety and treat the child conservatively to see if the hydronephrosis improves . Follow up scans revealed a decrease in hydronephrosis and a decompression of the ureterocoele.
However despite this procedure she developed recurrent UTI and the previously decompressed Ureterocoele appeared to balloon once again. The dilated system appeared to be filled with debris. She was admitted for parenteral antibiotics and a second puncture of the ureterocoele was undertaken. However 6 months down the line she developed yet another UTI. Following another course of parenteral antibiotics and cessation of the infection a Laparoscopic Right Upper Hemi Nephro-ureterectomy was performed and she recovered well.