Retrocaval ureter. A review of the literature with a report on two new cases followed for fifteen years and two years respectively

Right sided double inferior vena cava with obstructed retrocaval ureter: Managed with single incision multiple port laparoscopic technique using "Santosh Postgraduate Institute tacking ureteric fixation technique"

Right double inferior vena cava with obstructed retrocaval ureter is an extremely rare anomaly with only a few reported cases in the literature. To the best of our knowledge, this is the first case report describing ureteric repair by use of a single-incision laparoscopic technique. In addition, this report addresses the underlying surgical challenges of this repair and provides a brief review of the embryology of this anomaly. The "Santosh Postgraduate Institute ureteric tacking fixation technique" provides ease of end-to-end uretero-ureteric anastomosis in a single-incision laparoscopic surgery.

Ureteral obstruction caused by a duplicated anomaly of inferior vena cava

Developmental anomalies of inferior vena cava are a rare cause of ureteral obstruction. We report a case that presented with right upper ureteral obstruction that radiologically simulated a retrocaval ureter. An aberrant vessel, which caused obstruction of the right ureter was identified at operation and surgical relief of ureteral obstruction was performed. Inferior venocavography was performed postoperatively and disclosed an unusual incomplete duplication of inferior vena cava. Our findings suggested that ureteral obstruction by incompletely duplicated anomaly of the inferior vena cava should be included in the differential diagnosis of extrinsic ureteral obstruction.

Contemporary diagnosis of retrocaval ureter

PURPOSE

We describe a noninvasive radiologic evaluation of a retrocaval ureter using currently available technology.

MATERIALS AND METHODS

Three-dimensional volume-rendered CT and diuretic renography were performed for evaluation of a possible retrocaval ureter.

RESULTS

The 3D CT scan definitively diagnosed the retrocaval ureter, while diuretic renography showed no evidence of clinically significant obstruction. No invasive procedures were required.

CONCLUSION

A 3D volume-rendered CT scan in the excretory phase combined with diuretic renography is the radiologic evaluation of choice for patients with a suspected retrocaval ureter, as it is noninvasive yet highly accurate in its anatomic delineation.

Ureteral obstruction by a rare venous anomaly: a case report

Aberrant blood vessels are a rare cause of ureteral obstruction. A case is reported of right upper ureteral obstruction that simulated radiologically a retrocaval ureter. At operation the ureter was obstructed by an aberrant vein going from the right spermatic vein to the inferior vena cava. The obstruction was relieved by dividing this vessel. Aberrant blood vessels should be considered in the differential diagnosis of extrinsic ureteral obstruction.

The surgical treatment of retrocaval ureter

Ureteric obstruction resulting from retrocaval ureter may be due to either compression of the ureter by the vena cava or stenosis of the postcaval segment. If obstruction is due to stenosis, the commonly described operation of division and anastomosis through the proximal dilated ureter or pelvis, after repositioning of the ureter, is likely to fail, as is division of the vena cava itself. Excision of the postcaval segment with anastomosis of the spatulated ureter over a Silastic splint is therefore recommended. Three case histories of patients with retrocaval ureter treated surgically are presented and support this view.

Circumcaval ureter: a report of four cases in children with a review of the literature and a new classification

4 cases of circumcaval ureter presenting in childhood are reported. A review of the literature reveals that most cases recieve attention only later in life at a time when ureteric changes are not so readily reversible. A study of the course of the ureter reveals that 2 forms can be distinguished: a common Type I with a slter reveals that 2 forms can be distinguished: a common Type I with a low loop and kinking of the proximal ureter producing obstruction and a rare Type II with a high loop where there is no kinking and no obstruction. Ureteric remodelling on the ordinary principles formulated for congenital obstructions can give good results.

Urological complications following aortofemoral bypass graft

3 cases of ureteric obstruction secondary to aortic femoral bypass grafting are presented. This complication has been infrequently reported and we feel that it may be more common than is recognised. In all other published cases the ureter lay behind the prosthesis but the authors present a surgically proved case where the ureter lay in its normal position. The aseptic vascular reconstructive surgical procedures are to be preferred to ureteric reconstruction.