Abstract
BackgroundCongenital mid-ureteral stricture is a rare malformation of the ureter leading to prenatal and neonatal hydronephrosis. Site characterization of the narrowing is important to optimize the surgical approach to the newborn affected by hydronephrosis.Case presentationWe report a female EM with a rare form of hydronephrosis, (i.e. mid-ureteral stricture) which was detected early during pregnancy by imaging techniques. During fetal life both conventional fetal Ultrasound and maternal Magnetic Resonance Imaging (MRI) were used to diagnose the obstruction. Magnetic Resonance pyelography and retrograde Ureteropyelography were performed after delivery and before surgical correction and confirmed the finding.Furthermore, we revisited the literature using online MEDLINE and EMBASE databases. The literature reported only a few cases of prenatal diagnosis of early onset mid-ureteral stricture.ConclusionMid-ureteral stricture is a rare cause of prenatal hydronephrosis. The diagnosis should not be delayed in order to apply the appropriate surgical approach. As a result, we showed the usefulness of fetal MRI and postnatal Magnetic Resonance pyelography, in the event that radionuclide renography with Tc-MAG3 was less informative, to allow the detection of the site of ureteral narrowing. Intrasurgical retrograde ureteropyelography confirmed these findings.
Highlights
Congenital mid-ureteral stricture is a rare malformation of the ureter leading to prenatal and neonatal hydronephrosis
Mid-ureteral stricture is a rare cause of prenatal hydronephrosis
We showed the usefulness of fetal Magnetic Resonance Imaging (MRI) and postnatal Magnetic Resonance pyelography, in the event that radionuclide renography with Tc-MAG3 was less informative, to allow the detection of the site of ureteral narrowing
Summary
The mid-ureteral tract is rarely observed as the prenatal onset of urinary tract obstruction [9,17,18]. Smith et al looked at 4 new cases of mid-ureteral strictures and reviewed 13 previously reported cases. These authors found that the retrograde pyelography was diagnostic in all 17 cases [12]. Hwang et al reported 5 cases of this rare abnormality presented as prenatal hydronephrosis [9]. In these cases, both renal ultrasound and radionuclide renography did not reliably demonstrate the site of obstruction. To investigate the congenital mid-ureteral stricture we showed the feasibility of fetal MR and postnatal MR pyelography, in the case that radionuclide renography with Tc-MAG3 was less informative, to allow detecting the site of narrowing.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
