A case of right triplicate and left duplicate ureters

Ureteral triplication is a rare anomaly of the urinary tract. A 42-year-old male was found to have right triplicated and left duplicated ureters. The chief complaint was gross hematuria, but it disappeared after admission. Computerized tomographic scan, renal angiography and urine cytology revealed no pathological findings but 3 small aneurysms at the upper pole of the right kidney. Cystoscopic examination showed 3 ureteral orifices on the right side with bleeding from the lowest ureteral orifice. Right retrograde pyelography revealed 3 pelvic systems with calyceal communication of lower and middle pelvic system. Our case is consistent with altered type-D of Smith's classification.