RETROCAVAL URETER—UNUSUAL CAUSE OF URETERAL OBSTRUCTION

Abstract

The term retrocaval ureter is used interchangeably with circumcaval or postcaval ureter, which describes the anatomic relationship of the ureter to the embryologically abnormal inferior vena cava. The designation preureteric vena cava more accurately describes the embryologic malformation; however, this is not as practical a term because the functional abnormality is only manifest clinically by obstruction of the ureter. A retrocaval ureter courses toward the midline on the posterior aspect of the inferior vena cava before emerging medial and anterior to this structure and then descending into the pelvis. It is nearly always single and located on the right side. Hydronephrosis and hydroureter above the postcaval ureteral segment may develop if the vena cava produces sufficient obstruction. When obstructed, flank pain can occur with or without hematuria. Infection may also be present with the ureteral obstruction. In 1893, Hochstetter¹first described retrocaval ureter in man. He and others found