With duplex kidney and complete ureteral duplication, the upper renal and lower renal moieties are drained by separate ureters, each having its own ureteral orifice in the bladder. upper renal moiety ureter has ectopic insertion medial and inferior to the lower renal moiety ureter, and frequently ends in a ureterocele lower renal moiety ureter has orthotopic insertion lateral and superior to the upper renal moiety ureter, and vesicoureteral reflux can occur