Prenatal imaging features and postnatal outcomes of isolated fetal duplex renal collecting system: A systematic review and meta-analysis

Prenat Diagn. 2020 Mar;40(4):424-431. doi: 10.1002/pd.5622. Epub 2020 Jan 28.


Objectives: To perform a systematic review of studies reporting the outcome of fetuses with a prenatal diagnosis of isolated duplex collecting system (DCS).

Methods: Inclusion criteria were studies reporting the outcome of fetuses with a prenatal diagnosis of isolated DCS, defined as DCS not associated with other major structural anomalies at the time of diagnosis. The outcomes observed were: imaging features of DCS on prenatal ultrasound, associated anomalies detected exclusively at prenatal follow-up ultrasound and at birth, abnormal karyotype, symptoms at birth (including vesicoureteral reflux [VUR] and urinary tract infections [UTI]), need for and type of surgical approach, complications after surgery, and accuracy of prenatal ultrasound in correctly identifying this anomaly.

Results: Eleven studies (284 fetuses with a prenatal diagnosis of DCS) were included. On ultrasound, DCS was associated with ureterocele in 70.7% and with megaureter in 36.6% of cases. Worsening of pelvic/ureteric dilatation was reported to occur in 41.3% of fetuses. At birth, 4.3% of fetuses affected by DCS showed associated renal anomalies. After birth, VUR and UTI presented in 51.3% and 21.7% of children respectively, while 33.6% required surgery. Prenatal diagnosis of DCS was confirmed in 90.9% of included cases.

Conclusion: DCS diagnosed prenatally is associated with a generally good outcome. Prenatal ultrasound has a good diagnostic accuracy, while detailed postnatal assessment is required in order to identify associated renal anomalies.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Female
  • Humans
  • Infant, Newborn
  • Kidney
  • Kidney Pelvis / abnormalities
  • Kidney Pelvis / diagnostic imaging*
  • Kidney Pelvis / surgery
  • Pregnancy
  • Prognosis
  • Ultrasonography
  • Ultrasonography, Prenatal
  • Ureter / abnormalities
  • Ureter / diagnostic imaging*
  • Ureter / surgery
  • Ureterocele / diagnostic imaging*
  • Ureterocele / etiology
  • Ureterocele / surgery
  • Urinary Tract Infections / epidemiology*
  • Urinary Tract Infections / etiology
  • Urogenital Abnormalities / complications
  • Urogenital Abnormalities / diagnostic imaging*
  • Urologic Surgical Procedures
  • Vesico-Ureteral Reflux / epidemiology*
  • Vesico-Ureteral Reflux / etiology