Morphological aspects of the bifid ureter (in „Y”)

Our assessments on the bifid ureter resulted from the study on a number of 258 cases of renal upper pathways, using as study methods the dissection and the analysis of CT urographies. We met a total of 10 cases with bifid ureter, 4 cases on the right and 6 cases on the left, two of them showing a bilateral bifid ureter. In 8 cases the superior ureter drained only the upper part of the kidney and in 2 cases the two ureters had an equal drainage area. The superior ureteral was thinner than the lower one in 6 cases, in 2 cases the two ureters were equal in caliber and also in 2 cases the superior ureter was more voluminous than the lower one. Up to their confluence, the two ureters were linear, in one case the upper ureter was sinuous and in two cases the upper ureter describes a concave curve oriented laterally. The confluence of both ureters is most commonly on the medial margin of the kidney, under the renal hilum, an aspect we met in 7 cases. Located supero-medial to the lower ureter, the superior on showed several aspects up to the confluence with the lower one: a. passing along the medial face of the lower ureter, with a traject like a “gun barrel”, as seen in 2 cases; b. in 3 cases anteriorly crossed the lower ureter, with the confluence laterally; c. in 2 cases the superior ureter passed postero-medial to the lower one; d. in 2 cases the superior ureter went in front of the lower one; e. in one case the upper ureter have an oblique infero-medial trajectory while the lower one was supero-medial, their confluence being made under an acute angle on the medial margin of the kidney, above its inferior pole.