Subtle renal duplication as an unrecognized cause of childhood incontinence: diagnosis by magnetic resonance urography.
Urinary incontinence in young girls who have been toilet trained may be due to an ectopic ureter inserting below the urinary sphincter. This diagnosis is frequently delayed, is psychologically distressing, and may be missed at physical examination. Findings at ultrasound evaluation may be subtle and imaging with computed tomography or intravenous urography exposes young patients to ionizing radiation. We report two cases of girls with urinary incontinence where magnetic resonance (MR) urography revealed subtle renal duplication which implied the presence of an ectopic duplicated ureter with infrasphincteric insertion. These cases stress the importance of examining the kidneys, rather than the perineum, at MR, ultrasound and intravenous urogram evaluation, and show the value of MR urography as a safe alternative to computed tomography and intravenous urography for making this diagnosis.
Lipson
Jafi A
JA
Department of Radiology, University of California San Francisco, 505 Parnassus Avenue, Box 0628, M-372, San Francisco, CA, USA.
Coakley
Fergus V
FV
Baskin
Laurence S
LS
Yeh
Benjamin M
BM
D002675:Child, Preschool; D005260:Female; D006801:Humans; D007668:Kidney / Q000002:abnormalities* / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D014549:Urinary Incontinence / Q000209:etiology*; D014567:Urography / Q000379:methods
Radiographics. 2002 Sep-Oct;22(5):1139-64
12235344
Eur Radiol. 2002 Jun;12(6):1442-50
12042952
AJR Am J Roentgenol. 1991 Feb;156(2):365-6
1898815
Pediatr Radiol. 1998 Dec;28(12):942-9
9880638
AJR Am J Roentgenol. 1995 Apr;164(4):957-61
7726056