Prepuce transillumination: A safety tool in forceps guided circumcision

Maged Rihan, MD, MRCS

General surgery department, Faculty of medicine- Cairo university- Egypt 

Correspondence to:

Maged Rihan, MD, MRCS. E-mail:


Duplex renal system, a common congenital anomaly of the kidney and urinary tract, is preferably identified through screening. For obstructed symptomatic duplications, prompt relief of obstruction to forestall renal parenchymal loss is recommended. We present a case of neglected obstruction of the right upper moiety in an adult female with discordant bilateral renal duplex system.

A 49-year-old female with 10-year history of recurrent right flank pain and recurrent fever presented for clinical evaluation and treatment. She had no such symptoms in early childhood. A diagnosis of obstructed right upper renal moiety in bilateral discordant renal duplication with complete moiety parenchymal destruction was made. She had right renal exploration with complete excision of the hydronephrotic sac and the grossly dilated moiety ureter down to the obstruction at the fusion of both upper and lower moiety ureters. Her post-op period was uneventful. She is symptom-free and her urinary tract is structurally intact.

It is possible that hitherto asymptomatic renal duplication becomes symptomatic in early adulthood from intrinsic moiety ureter obstruction. This suggests that there is need for lifetime monitoring of persons with duplex renal systems. Late presentation with neglected symptoms, and consequent renal moiety destruction as seen in this woman is a result of absence of such monitoring.

Keywords: Duplex renal system, Obstruction.

Ann Afr Surg. ****; **(*):***


Conflicts of Interest: None

Funding: None

© 2020 Author. This work is licensed under the Creative Commons Attribution 4.0 International License.


The Annals of African Surgery is the official publication of the Surgical Society of Kenya.


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