CASE REPORT: PARTIAL NEPHRECTOMY IN A PATIENT WITH BILLATERAL DOUBLE COLLECTING SYSTEM
Suryadi* Eka Yudha Rahman**
*Resident of The Surgeon Education Program, Faculty of Medicine and Health Sciences, Lambung Mangkurat University/Ulin Hospital Banjarmasin,
Banjarmasin, Indonesia
**Staff of Urology Division, Surgical Department, Faculty of Medicine and Health Science, Lambung Mangkurat University/Ulin Hospital Banjarmasin,
Banjarmasin, Indonesia
Corresponding Author: [email protected]
ABSTRACT
Introduction: Double collecting system (DCS) is an abnormality of the urinary tract in the presence of two pelvic systems in the kidney. It occurs in 0.7 - 4% of the population, mostly in females. The disorder is generally asymptomatic, but its presence may increase the risk of recurrent complex urinary tract infections, vesicoureteral reflux, urinary incontinence, hydronephrosis, or impaired renal function.
Case report: A 33-year-old female patient was reported with symptoms of left low back pain. Sometimes accompanied by complaints of pain and pus-like discharge while urinating. Urological CT-scan examination revealed double pelvocalyceal
system incomplete dextra and complete sinistra, hyronephrosis and hydroureter sinistra grade 4 upper moiety ren sinistra with non-functional PCS. The patient underwent the first operation to relieve swelling of the left kidney by inserting a stent and 6 months later the patient underwent Partial Nephrectomy Upper Moiety in the second operation.
Discussion: There are two types of DCS based on the junction of the two ureters before draining into the bladder, which are complete DCS and partial/incomplete DCS. Medical and surgery intervention are not required in cases of asymptomatic DSC. Surgical treatment is necessary for those who have complications related to DCS. Upper pole heminephrectomy is considered as an effective and definitive surgery, particularly for poorly functioning upper pole moiety.
Conclusion: DCS is an anatomical congenital abnormality. By increasing the age, those patients are highly at risk of recurrent urinary tract infections and renal impairment.
