DIAGNOSING THE COMBINATION OF RENAL DYSGENESIS, GARTNERS DUCT CYST AND IPSILATERAL MULLERIAN DUCT OBSTRUCTION

Purpose: We describe the differential points in the diagnosis of the c ombination of renal dysgenesis, Gartner's duct cyst and ipsilateral mu llerian duct obstruction. Various imaging studies and urological proce dures were performed. We report our experience in detecting these anom alies in 10 girls and review the literature. Materials and Methods: Te n girls, 7 to 13 years old, with this combination of anomalies were id entified in the last 10 years. Imaging studies as well as urological p rocedures were selectively performed, especially at puberty following menarche. Patients received long-term followup with ultrasound. Result s: Cystic dilatation of Gartner's duct protruded into the bladder and presented as a ureterocele in 5 patients and posterior to the bladder in 5. Surgical removal of a partial portion of a Gartner's duct cyst w as performed in 5 patients for alleviation of urinary symptoms. Unilat eral mullerian duct obstruction was demonstrated in all 10 patients. E xcision of the vaginal septum was performed in 6 patients for relief o f genital obstruction. Conclusions: When cystic dilatation of the pelv is, especially a ureterocele-like cyst without ureteral dilatation, is found in girls with ipsilateral renal dysgenesis, the possibility of a Gartner's duct cyst should be considered. For early detection and tr eatment of unilateral obstruction of duplicated mullerian ducts pelvic sonography should be performed at puberty, especially just after mena rche, in girls with renal dysgenesis and ipsilateral Gartner's duct cy st.