Robert L. Lebowitz, M.D. Children' s Hospital, Harvard Medical School Boston, Massachusetts

Prenatal diagnosis of hydronephrosis led to a VCUG that showed a ureterocele in the bladder (figure 1). The ureterocele effaced and there was reflux into a lower group of calyces and a middle group of calyces, each with its own ureter but no visualization, by reflux, of the upper moiety (figure 2).

An IVP showed a normal middle and lower pole of the kidney, each with its own ureter, but nonvisualization of the upper pole (figure 3). The upper pole ureter ended in the large ureterocele. This is an example of triplication of the left ureter. The upper pole ureter ended in a ureterocele. The other two ureters refluxed.