The patient was a 2 years old female child with bilateral complete duplex system, with severe hydroureteronephrosis of the right upper moiety due to reflux.
After proper workup the child was taken for surgery, preoperative cystoscopy was done to confirm the location of all the ureteric orifices. The right upper moiety ureteric orifice was found to be grossly dilated and refluxing and was present right at the bladder neck. As bladder neck is a dangerous area for dissection and can lead to incontinence, a different approach was adopted. The refluxing right upper moiety ureter was transected close to the bladder and the distal end closed. While the proximal end was anastomosed end to side to the normal right lower pole moiety ureter, thus taking care of reflux as well as providing drainage to the right upper moiety (ureterouretrostomy).
The child was discharged uneventfully on 5th postoperative day.
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