Hemi-Nephrectomy of Duplex Kidney combined with Ureterectomy

Dr. Sumata Mishra, Bhubaneshwar 

MBBS, MS (General Surgery), MCh (Urology), DNB Genitourinary Surgery  Urologist

Our bodies are complex mechanisms functioning in perfect harmony on their own. Sometimes, people are born with congenital defects that complicate their functioning resulting in noticeable symptoms in their health. One such defect is the duplex kidney, and its complication results in hydronephrosis.  

Hemi-Nephrectomy of Duplex Kidney combined with Ureterectomy:

Too many new terminologies, isn’t it? Dr. Sumata Mishra, a practicing surgeon, and Urologist in Bhubaneshwar is also an Assistant Professor in the Urology department of KIMS and heads the department of Renal Transplant Surgery.

Dr. Sumanta Mishra has tried to explain this case he came across in brief.

Let’s begin by knowing the terminology here.

What is Hemi Nephrectomy?

Hemi Nephrectomy is a procedure that the surgeons carry out to remove a part of the kidney. Removing the non-functional part of the kidney allows the rest of the kidney to function properly.

Usually, a person with a duplex kidney may have to undergo this procedure.

The surgeon can either use the laparoscopic technique or the conventional open surgery. 

The choice of surgery is circumstantial. Sometimes the surgeon may choose to go for laparoscopy, but if they find the approach impossible or complex, they may have to go for open surgery.                                                                                                                                                       

What is Duplex Kidney?

Duplex Kidney is a condition that a person is born with. Here, the kidney has two ureters instead of one.

The ureter is the tube that carries the urine to the bladder.

In some cases, both the ureters of a single kidney may connect directly into the bladder, or at times the ureters join into one, and then a single tube joins the bladder.

How does one know if they have a duplex kidney?

Usually, this deformity goes unnoticed if the kidney keeps functioning normally. But in some cases, this deformity may cause:

  • Vesicoureteral reflux – The urine flows back into the ureter, and the kidneys damaging the kidneys in the long run. 
  • A urinary tract infection results in scarring of the kidney.
  •  In some rare cases, one of the ureters of a duplex kidney is connected to some other organ instead of the kidney. So, the urine will drain into the other organ, damaging that organ.

After explaining the new terms that we are reading about, Dr. Sumanta Mishra went on to explain about the symptoms and the treatment plan for a duplex kidney.

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What are the symptoms of a malfunctioning Duplex Kidney?

A person suffering from a malfunctioning duplex kidney may show the following symptoms:

  •  A urinary tract infection may result in pain, burning sensation, and the urge to urinate   frequently, all though the bladder is empty.
  • You may notice blood in your urine combined with lower back pain.
  •  Reduced appetite
  •  Swelling or lump near the stomach.

When you visit your doctor for the mentioned symptoms, the doctor may ask you to take some tests to determine the cause of your symptoms. The doctor may ask you to undergo:

  •   Blood test
  •   Ultrasound
  •   MRI
  •  CT scan

This is where your condition will be visible to the doctor, enabling a treatment course.

What is the treatment for Duplex Kidney?

Usually, a person suffering from duplex kidney may have to undergo Hemi Nephrectomy.

If it is possible to treat the urine infection with medicines, the doctor will avoid surgery.

Besides hemi nephrectomy, the doctor may also remove the faulty ureter. This surgery is called Ureterectomy.

What is the process of heminephrectomy?

Your surgeon will ask you to get admitted to the surgery the previous night.

You will be kept on fast for 12 hours before the surgery.

The nurse inserts an IV line for medications and fluids.

On the day of the surgery, the nurse checks all your vitals before taking you for the surgery.

On the surgery table, the anesthetist will administer anesthesia.

In Laparoscopic surgery, the doctor will make a small incision and carry out the minimally invasive procedure. A catheter will be attached to your bladder until you can resume normal function.

Since it is a minimally invasive procedure, you will be discharged after 2 – 3 days.

However, the doctor will have to cut through many layers to get your kidney to carry out the surgery in conventional surgery. In some cases, the doctor may have to take out a rib if they cannot approach your kidney.

In open surgery, you may be required to stay in the hospital for at least 5 to 7 days since the dressing has to be changed often. 

Once the doctor realizes that there is no oozing or bleeding from the surgical wound site, you will be discharged to go home.

What are the post-operative care instructions?

Other than the prescribed medications for pain relief, the doctor may ask you to adhere to a strict diet for a few days.

The doctor will also instruct you to avoid any strenuous physical activity.

What are the risks involved in having the surgery?

Usually, the surgery goes off without any complications; however, in some cases, a person may suffer from infection, bleeding, or damaged organs near the kidney.


It is a well-known fact that a person can have an everyday life with just one kidney. So, if the other kidney has undergone partial removal, the rest of the kidney will still continue to function well.

However, if both the kidneys have undergone Hemi nephrectomy, there are chances of Kidney failure at a later stage. In such cases, a Kidney transplant is the only option other than undergoing dialysis.

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