title: Ureteral quadruplication associated with ureteral cyst and massive vesicoureteral reflux treated by laparoscopic nephroureterectomy.
abstract: OBJECTIVE
  Ureteral quadruplication is an extremely unusual developmental abnormality. We present the eighth reported case but the first to be associated with a ureteral cyst, with massive vesicoureteral reflux that was treated with laparoscopic nephroureterectomy.
  
  
  METHODS
  A 3-year-old boy was evaluated for recurrent urinary-tract infection. Massive left-sided vesicoureteral reflux associated with incomplete ureteral triplication was identified. A DMSA scan disclosed impaired function of this kidney. An uneventful total laparoscopic nephroureterectomy was performed at which a fourth atresic ureter was identified. All the four proximal ureters opened into a large ureteral cyst, and a distal monoureter opened into the bladder.
  
  
  CONCLUSIONS
  The patient recovered fully and was asymptomatic 6 months postoperatively.
authors: Department of Urology, Clinics Hospital of the University of São Paulo, São Paulo, Brazil. fabio.vicentini@sbu.org.br
authors: Fabio Carvalho
authors: FC
authors: Vicentini
authors: Francisco Tibor
authors: FT
authors: Denes
authors: Miguel
authors: M
authors: Srougi
mesh_terms: D002675:Child, Preschool; D003560:Cysts / Q000150:complications* / Q000000981:diagnostic imaging; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D009392:Nephrectomy / Q000379:methods*; D014513:Ureter / Q000000981:diagnostic imaging / Q000601:surgery*; D014515:Ureteral Diseases / Q000150:complications* / Q000601:surgery*; D014567:Urography; D014718:Vesico-Ureteral Reflux / Q000150:complications* / Q000000981:diagnostic imaging