On 24/7, Dr. Nguyen Dinh Lien, Head of the Department of Urology and Andrology at Hanoi's E Hospital, described the case as exceptionally rare. The unusual development stemmed from an abnormality in the ureteral bud during fetal development, resulting in 4 kidneys instead of the usual 2.

The patient had undergone ureteral stone removal surgery in Ho Chi Minh City 15 years prior. Recently, experiencing back pain and cloudy urine, she self-medicated at home without relief. Her family then brought her to E Hospital for examination.

Diagnostic imaging revealed a ureteral stone causing urinary stasis in the lower left kidney unit, within a complete duplicated kidney structure on both sides. The situation was further complicated by a ureteral stricture from the previous surgery, presenting a significant challenge for the surgical team.

The medical team performed a ureteral dilation procedure, placing drainage tubes in both ureters and draining the stagnant kidney to stabilize the patient's condition. A week later, endoscopic lithotripsy successfully removed the ureteral stone, and the patient recovered well.

X-ray image of the patient. Photo: *Doctor provided*

Dr. Lien explained that some individuals have congenital anatomical variations leading to internal differences undetectable externally. Such anomalies are typically discovered during medical checkups and diagnostic imaging. Normally, each ureteral bud forms one kidney, but in this case, an unusual split created 4, increasing the risk of stone formation.

The doctor recommended seeking immediate medical attention for any unusual symptoms, avoiding self-medication, which can complicate conditions and make treatment more difficult and costly.

Thuy Quynh