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ORIGINAL ARTICLE |
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| Year : 2002 | Volume
: 18
| Issue : 2 | Page : 129-130 |
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Supernumerary nipples and urinary tract abnormalities
Suresh Bhat, Appu Thomas, RN Sharma, Jacob Cherian, Shanmughadas
Departments of Urology and Medicine, Medical College, Kottayam, India
Correspondence Address:
Suresh Bhat
Medical College, Kottayam (Kerala) - 686 008
India
 Source of Support: None, Conflict of Interest: None  | Check |
 Abstract | | |
A high rate of association between supernumerary nipples (SNN) and genitourinary abnormalities has been reported previously. We examined all patients attending one particular unit, in the age group between 12 and 20 years for the presence of SNN and urinary tract abnormalities. We could find only a weak association between these two conditions.
Keywords: Supernumerary Nipple; Urinary Tract Abnormalities.
How to cite this article:
Bhat S, Thomas A, Sharma R N, Cherian J, Shanmughadas. Supernumerary nipples and urinary tract abnormalities. Indian J Urol 2002;18:129-30 |
| Introduction | |  |
A supernumerary nipple is a small pigmented or pearl colored mark found along the mammary ridge and is most commonly located below the normal position of the nipple. It represents a minor developmental anomaly and has an incidence of 0.22-2.5%. [1] Other significant malformation associated with SNN include cardiac, particularly ventricular septal defect. [2]
| Materials and Methods | | |
All the patients between 12 and 20 years who attended a particular medical unit from January 1999 to December 2000 were examined for SNN. Those patients with SNN underwent ultrasonography (US) of the abdomen and when indicated an excretory urography (IVU).
| Observation | | |
Altogether there were 1278 patients, which included 751 girls and 527 boys. SNN was seen in 21 boys and 13 girls. However urinary tract abnormalities were seen in only two patients. One 13-year-old boy had left pelviureteric junction obstruction (PUJO) and an 18year-old patient had right PUJO.
| Discussion | | |
In 1979, Mehes reported an association between renal abnormalities and SNN in 8 of 20 (40%) Hungarian children. [3] Most of these children had obstructive uropathy. A similar high association was observed by Versano et al in Israel. [4] 6 of 26 (23%) had urinary tract abnormalities. The common abnormalities noted included unilateral multicystic kidney, unilateral renal agenesis, duplication, hydronephrosis, conjoined kidney and vesicoureteral reflux.
In contrast to the above reports, Mimouni et al [1] , Robertson et al [5] and others could not demonstrate any urinary tract abnormalities in association with SNN. However in 1987, Hersch et al [6] examined 65 patients with SNN and found significant renal anomalies in 7 patients (11%). Based on their findings, they proposed the following conclusions: an SNN/ renal defect probably exists; the presence of an SNN in an otherwise normal individual with recognizable pattern of human malformation, not associated with renal abnormalities or central nervous system dysfunction, does not appear to be an indication for additional diagnostic studies of the urinary tract; race may have an influence on the association between SNN and urinary tract abnormalities in that black people did not demonstrate this association.
The incidence of major structural urinary tract malformation in a normal population is approximately l% [7] . Previous studies reported an incidence of 17.5% urinary tract abnormality in patients with SNN. [6] Opitz has described developmental fields which are those parts of the embryo in which process of development of complex structures appropriate to those parts are controlled and co-coordinated in a spatially ordered, temporally synchronized and epimorphically hierachical manner. [8]
Our own study revealed a weak association of SNN and urinary tract abnormalities. This probably, as described by Hersch et al, is due to genetic differences. Hence it may not be necessary to screen our population with SNN for urinary tract abnormalities.
| References | | |
| 1. | Mimouni F, Merlob P, Reisner SH. Occurrence of supernumerary nipples in newborns. Am J Dis Child 1983; 137: 952-953.  |
| 2. | Sanfilipo JS, Gynecologic problems of childhood. In: Behrman RE, Kleigman RM, Jennson HB eds. Nelson's Textbook of Pediatrics. 16 th ed. Philadelphia, Saunders, 2000: 1664. |
| 3. | Meher K. Association of supernumerary nipples with other anomalies. J Pediatr 1979; 95: 274-27. |
| 4. | Versano IB, Jeber L, Gartz BZ et; I. Urinary tract abnormalities in children with supernumerary nipple. Pediatrics 1984; 73: 103-105. |
| 5. | Robertson H, Sale P, Sathyanarayan C. Lack of association of supernumerary nipples with renal anomalies in black infants. J Pediatr 1986; 109: 502-503. |
| 6. | Hersch JH. Bloom AS, Cromer AO, Harrison HL, Weisskopf B. Does a supernumerary nipple/renal field defect exist? Am J Dis Child 1987; 141: 989-991. |
| 7. | Klineberg M, Chemke RCJ, Levin S. An epidemiological study of congenital malformations among different ethnic and social groups in Israel. Dw Med Child Neurol 1971: 13: 735-745. |
| 8. | Opitz JM. The developmental field concept in clinical genetics. J Pediatr 1982; 101: 805-809. |
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