Bladder
Congenital anomalies
Duplication

Author: Alcides Chaux, M.D. (see Authors page)

Revised: 8 March 2016, last major update April 2011

Copyright: (c) 2003-2016, PathologyOutlines.com, Inc.

PubMed Search: Bladder congenital anomalies duplication
Cite this page: Duplication. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/bladderduplication.html. Accessed December 3rd, 2016.
Definition / General
  • Bladder is separated into complete or incomplete compartments, either in the sagittal or coronal plane
  • Variants include double bladder, septal bladder and hourglass bladder
Epidemiology
  • Rare, <100 cases reported
  • Equal male:female ratio
Etiology
  • No single explanation for all cases of bladder duplication
  • Complete duplication of bladder and hindgut probably occurs because of partial twinning of the tail portion of the embryo
  • Excessive constriction of ventral cloaca or a supernumerary cloacal septum may lead to bladder duplication in the coronal plane
  • Complete bladder duplication with diphalia may be explained by duplication of the cloaca
Clinical Features
  • Varies from intravesical septum to complete duplication of lower urinary tract
  • Complete duplication means two bladders, each with a full thickness muscularis propria and its own ipsilateral ureter, half the trigone, and a urethra; may occur in coronal or sagittal planes
  • Sagittal duplication (the most common): each bladder receives the ureter of ipsilateral kidney, separated from the other by a peritoneal fold and loose areolar tissue, is more often associated with non-urological anomalies than coronal ones
  • Coronal duplication: two bladders lying in front of each other, separated by an oblique (posterosuperior to anteroinferior) fibromuscular septum
  • Incomplete duplication consists of two bladder halves separated by a thick muscular wall, both draining into a common urethra
  • Associated with other GI (36-42%) and GU (38-90%) anomalies, including caudal duplication syndrome (Am J Dis Child 1993;147:1048)
  • Anomalies (and treatment) may vary by patient (Urology 2000;55:578)
  • Incomplete emptying may cause urinary tract infections, although most patients are asymptomatic
Case Reports
Treatment
  • In some cases, needed for infections or to achieve continence
Clinical Images

Images hosted on other servers:

Cystourethrogram shows complete bladder duplication

Ultrasound shows complete bladder duplication