The two orifices are characteristically inverted, in relation to the collecting system that each ureter drains. The upper pole ureter is more commonly obstructed, while reflux is more often the problem in the lower pole ureter. These ureters adjoin each other before entering the bladder. In many instances the diagnosis of a duplicated ureter is incidental and usually causes no functional disturbance. However, there may be an association of reflux, obstruction, urinary tract stasis, and urinary tract infection with duplication.
Urinary stasis is common in cases of bifid ureter.
Urine can reflux into the other branch of the 'Y' shaped ureter instead of flowing down the shared stem. The most common presenting symptom of young girls is a continuous dribbling or wetness after being toilet trained, and urinary tract infections. The wetness is often due to a duplicated ureter or urethra with the orifice in the uterus, cervix, or vagina. Males do not experience incontinence. Hydronephrosis is relatively common in cases of duplication.