Double ureteral jets unilaterally + bladder calculus, ultrasound and color Doppler imaging

When observing double ureteral jets on the left side, with a normal single jet on the right, normal kidneys, and a urinary bladder calculus, several possibilities arise. The most common is a duplicated collecting system, where two ureters drain one kidney, each with its own ureteral orifice at the vesicoureteric junction (VUJ). Ureteral duplication with one ectopic ureter, ureterocele (cystic dilation of the distal ureter), and vesicoureteral reflux (VUR) are other possibilities. Rarely, crossed fused renal ectopia, where one kidney crosses midline and fuses with the other, could cause abnormal jets. Bladder structural anomalies can also alter jet patterns, with a bladder calculus potentially exacerbating symptoms.

To diagnose, further imaging is needed: a voiding cystourethrogram (VCUG) evaluates reflux and ureteral anatomy; intravenous urography (IVU) or CT urography provides detailed imaging; MRI urography offers radiation-free detailed images; and cystoscopy allows direct visualization of the bladder and ureteral orifices. In conclusion, double ureteral jets often indicate a duplicated system, and the bladder calculus may be incidental or contributory, warranting comprehensive evaluation.