Urology: ectopic ureter in a duplex system: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

General Surgery · Urology: ectopic ureter in a duplex system

Sample item

A 4-year-old girl has been constantly damp since toilet training although she voids normally. Ultrasound shows a duplex left kidney with a hydronephrotic upper moiety. Which ureter is responsible for her incontinence, and where does it insert?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Ureter of the upper moiety, inserted ectopically distal and medial to the normal site

In a duplex system the Weigert-Meyer rule states that the upper moiety ureter inserts inferior and medial, and may be ectopic or obstructed, while the lower moiety ureter inserts lateral and cranial and tends to reflux. In girls, ectopic insertion below the sphincter, into the urethra or vagina, causes continuous dribbling despite normal voiding.

Option by option

  • A. A single ureter from the duplex kidney, inserted normally into the trigone

    A normally inserted ureter cannot produce continuous wetting.

  • B. Ureter of the upper moiety, inserted ectopically distal and medial to the normal site (correct)

    Correct. The upper moiety ureter inserts ectopically, in the urethra or vagina in girls, causing continuous leakage.

  • C. Both ureters, inserted normally into the bladder

    Normal insertions do not explain leakage with normal voiding.

  • D. Ureter of the lower moiety, inserted ectopically above and lateral to the normal site

    The lower moiety ureter inserts higher and lateral and tends to reflux, not to cause continuous incontinence.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More General Surgery questions

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is B, Ureter of the upper moiety, inserted ectopically distal and medial to the normal site. In a duplex system the Weigert-Meyer rule states that the upper moiety ureter inserts inferior and medial, and may be ectopic or obstructed, while the lower moiety ureter inserts lateral and cranial and tends to reflux.

Why is "A single ureter from the duplex kidney, inserted normally into the tr…" not the answer?

A normally inserted ureter cannot produce continuous wetting.

Why is "Both ureters, inserted normally into the bladder" not the answer?

Normal insertions do not explain leakage with normal voiding.

Why is "Ureter of the lower moiety, inserted ectopically above and lateral to…" not the answer?

The lower moiety ureter inserts higher and lateral and tends to reflux, not to cause continuous incontinence.

What concept does this question test?

It tests Urology: ectopic ureter in a duplex system in General Surgery. In girls, ectopic insertion below the sphincter, into the urethra or vagina, causes continuous dribbling despite normal voiding.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Urology: ectopic ureter in a duplex system?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.