Background: Double Ureter is one of the anomaly of urethra that appears complete or incomplete. Incomplete duplication of Ureter is known as bifid Ureter, this kind of anomaly may be formed due to some error or disturbance in development of the Ureteric bud which arises from the mesonephric duct around the 5th week. The Ureteric bud grows and penetrates in to the metanephric tissue at about 32 cond day. However, sometimes the Ureteric bud may divide before penetrating the metanephric tissue thus, giving rise to a bifid Ureter having a single opening in to the bladder. According to recent studies (in the year 2000) on an average 3% excretory urograms show Ureteral duplication, and the reference book of Grant's range it around 0.5%. Case report: The present report is a rare case of a male cadaver aged about 65 years which has been dissected for medical students in department of anatomy. In dissection of abdominal cavity we have found that both kidneys including the liver, spleen, renal veins and inferior vena cava are unexpectedly has become enlarged, also we have recognized that the left Ureter has been doubled and it ran to the rime of the true pelvis, then it joined together and connected to the bladder. The right Ureter however, was completely normal, but the pelvis has been doubled instead. Conclusion: The majority of the investigations have reported this anomaly in association with other disease conditions but the present case is the unilateral incomplete bifid Ureter & pelvis were associated with no other abnormality. The possible embryological reasons for the formation of bifid Ureter are discussed.

 introduction: Crimean-Congo hemorrhagic fever (CCHF), an acute viral disease in humans, is characterized by extensive ecchymoses, bleeding, and hepatic dysfunction and is associated with a 30% case-fatality ratio. We describe the clinical, and laboratory findings and the role of supportive and antiviral therapy for 2 patients who received a diagnosis of Crimean- Congo hemorrhagic fever (CCHF). The patients had immunoglobulin M antibodies results positive for CCHF virus in blood. One of the patients was considered to have severe case of CCHF with clinical picture of fever, headache, abdominal pain, myalgia, drowsiness, epistaxis, hematemesis, and hepatitis. One of the patients was given ribavirin, and both survived. Conclusion: We suggest using ribavirin to treat patients, particularly those with severe cases. 

Introduction: The aim of this study was to report our 23-year experience in the diagnosis and treatment of retrocaval Ureter. Materials and Methods: Data from 13 patients with retrocaval Ureter were reviewed. Intravenous urography and retrograde pyelography had been used for confirming the diagnosis. All of the patients had been symptomatic and undergone surgery. A control intravenous urography had been performed 6 months postoperatively. Results: The mean age of the patients was 23 years (range, 12 to 37 years). Twelve patients (92.3%) were men. The clinical manifestations were pyelonephritis in 7 (53.8%), right flank pain in 4 (30.8%), gross hematuria in 1 (7.7%), and Ureteral calculus in 1 (7.7%). All of the patients had type 1 right-sided retrocaval Ureter. Associated anomalies were seen in none of the patients. The control intravenous urography showed improvement of renal function. Conclusion: In our patients, the most common cause of referral was pyelonephritis. In symptomatic cases, operation is needed and can improve renal function.    

Purpose: The Mechanical properties of the Ureteral wall may be altered by certain diseases such as megaUreter. Ureter compliance and wall tension alterations can occur, leading to some abnormalities such as reflex mechanisms. Familiarizing with the mechanical properties of the Ureter can help us advance in the understanding of urinary tract diseases. Materials and Methods: A constitutive model that can predict the mechanical response of Ureteral tissue under complex mechanical loading is required. Parameters characterizing the mechanical behaviour of the material were estimated from planar biaxial test data, where human Ureter specimens were simultaneously loaded along the longitudinal and circumferential directions. Results: The biaxial stress-stretch curve was plotted and fitted to a hyperelastic four-parameter Fung type model and five-parameter Mooney-Rivlin model. The average strength in the longitudinal direction was 3. 48 ± 0. 47 MPa and 2. 31 ± 0. 46 MPa (P <. 05) for the circumferential direction. In the Fung model the value of parameter a2 (0. 699 ± 0. 17) was higher than a1 (0. 279 ± 0. 07), which may be due to the collagen fiber orientation’ s preference along the longitudinal axis. Conclusion: According to this study, it seems that Ureter tissue is stiffer in the longitudinal than in the circumferential direction and maybe the collagen fiber are along the axial axes. Also the specimens showed some degree of anisotropy.

Purpose: loss of significant lengths of Ureter when substitution with bowel or bladder fails is a disaster in urology. This study is conducted to evaluate the results of subcutaneous nephron-vesical bypass (SNVB) in Ureteral damage of different etiologies. Materials and Methods: Seventeen SNVB were employed in patients with Ureteral injuries. We employed a device consisted of an internal silicone tube covered by a coiled PTFE tube to replace the Ureter. This is called artificial Ureter (AU). Proximal end of the AU was introduced in the kidney percutaneously, the tube was passed through a subcutaneous tunnel, while the distal end was inserted in the bladder through a small suprapubic incision. Results: Follow-up ranged from six months to ten years. We removed the prosthetic Ureter in one patient due to gross hematuria two months after insertion. One of the patients was reoperated two days after the procedure because of urinary leakage. In all other patients, the procedure was safe and effective. Conclusion: Subcutaneous nephron-vesical bypass is a safe and appealing alternative to a nephrostomy tube. This is a permanent device with no need for exchange. The technique can be applied in Ureteral injuries due to various causes.

Ureteral anomalies, ectopic Ureter being one of them, are of the most important urogenital abnormalities because they directly affect kidney function. Several techniques have been used for treatment of ectopic Ureter. The goal of obstruction relief can be achieved by either Ureteropyelostomy or common sheath Ureteral reimplantation for a duplicated system, or reimplantation for a single system. Heminephrectomy and Ureteropyelostomy are well described elsewhere, but several technical points deserve emphasis. Laparoscopic procedures putatively offer reduced morbidity due to less postoperative pain, earlier return of gastrointestinal function, earlier discharge, and a quicker return to work. To our knowledge laparoscopic reimplantation for ectopic Ureter has not been reported, yet. We performed laparoscopic Ureteral reimplantation on a 29-year-old man with ectopic Ureter.

Purpose: To evaluate the efficacy and safety of endoscopic resection of lower Ureter in upper urinary tract tumor cases. Materials and Methods: Five patients with transitional cell carcinoma (TCC) of the upper urinary tract were enrolled in this study. Nephrectomy was carried out through a flank incision and distal Ureter with a cuff of bladder, which was removed using endoscopic approach. Complications and recurrence rate were evaluated. Results: A total of 5 patients with upper urinary tract tumor underwent the endoscopic resection of lower Ureter. All the patients had grade I transitional cell tumor. Two patients had suffered from bladder TCC treated previously. During the follow-up two cases developed bladder tumor: one, 18 months and another, one year postoperatively, both in the base of bladder, which was managed successfully by transurethral resection (TUR). Conclusion: Endoscopic resection of lower Ureter in selected patients with upper urinary tract tumors can lead to lower morbidity, shorter operation time, and higher patients satisfaction. Despite the minority of cases in this study, it seems that this method is applicable in selected cases.