A case of trifid pelvis with ureteropelvic junction obstruction

Trifid pelvis is one of the most rare congenital malformations of the upper urinary tract. Ureteropelvic junction obstruction (UPJO) is the most common congenital abnormality of the ureter. Coexistence of these conditions is extremely rare. A 54-year-old man was admitted to the Department of Urology with left flank pain and frequent urinary infection. Urinary system radiography revealed a few radio-opacities of 4-5 mm in diameter on the left side of the L3 vertebra. Delayed intravenous urography showed probable left UPJO and dilated left pelvic system. On the scintigraphy, atrophic left kidney with low-level of perfusion and concentration functions and with long extraction time was observed. Computed tomography urography revealed left UPJO and a severely dilated left pelvic system; the right kidney was completely normal. During surgical exploration, three renal pelvises joined to a common pelvis with UPJO.