Retrocaval Ureter Research Articles

MULTIDETECTOR-ROW COMPUTED TOMOGRAPHIC CHARACTERISTICS OF PRESUMED PREURETERAL VENA CAVA IN CATS.

Preureteral vena cava (circumcaval ureter, retrocaval ureter) occurs in a third of the feline population and has been associated with ureteral strictures in humans. The aim of this retrospective cross-sectional study was to describe the contrast-enhanced multidetector row computed tomographic (MDCT) characteristics of presumed preureteral vena cava in a group of cats. Medical records from two institutions located in different continents were searched from 2010-2013 for cases with complete contrast-enhanced MDCT examinations of the abdomen (i.e. included the entire course of the ureters and prerenal and renal segments of the caudal vena cava) and a diagnosis of preureteral caudal vena cava. For cases meeting inclusion criteria, CT scan data were retrieved and characteristics of the preureteral caudal vena cava were recorded. Presence of concomitant renal or ureteral diseases was also recorded. A total of 272 cats had contrast-enhanced abdominal CT scans during the study period and of these, 68 cats (22.43 ± 4.96%) had a diagnosis of presumed preureteral vena cava. In all affected cats, a "reverse-J ureter" was observed, i.e. a ureter running medially at the level of L4-5, passing dorsally to the caudal vena cava and then exiting ventrally between the caudal vena cava and aorta returning to its normal position. Having a preureteral vena cava resulted in an increased risk for concurrent urinary signs (OR = 3.00; CI: 95%; 1.28-6.99; P = 0.01). Findings supported the use of contrast-enhanced MDCT for characterizing morphology of preureteral vena cava and its relation with ureters in cats.

Retrocaval ureter which is a rare congenital anomaly

Retrocaval ureter which is a rare congenital anomaly

Uretere Retrocave: Deux Nouvelles Observations à L’hopital Du Point G A Bamako

Herein, we report two cases of right retrocaval ureter type I and II in two patients, aged 23 and 27 years. The presenting symptoms were right flank pain with fever. Imaging studies made the diagnosis of retrocaval ureter in one case and a pyelo-ureteral syndrome in the other case at operation.A Satisfactory result was obtained by JJ fixation in one case and by lumbotomy with rotating the ureter in the other case.

Retroperitoneal laparoscopic ureteroureterostomy for retrocaval ureter: A report of 15 cases

AimThe aim of the current study was to present our techniques and experience with retroperitoneal laparoscopic ureteroureterostomy (LUUS) in 15 patients with retrocaval ureter.Patients and MethodsA total of 15 patients with retrocaval ureter underwent retroperitoneal LUUS. A four‐port, finger and balloon‐dissecting, retroperitoneal approach was used. Follow‐up studies were performed with renal ultrasonography and intravenous pyelography.ResultsAll operations were completed laparoscopically without conversion to open surgery. The mean operative time was 120 (90∼170) min. The mean blood loss was 30 (15∼50) mL. All of the patients had an uneventful recovery. No intraoperative or postoperative complications occurred. At follow up, 3 and 6 months after discharge, remarkable improvement in the ureteral obstruction was observed.ConclusionsOur results indicate that retroperitoneal LUUS is a safe, effective and minimally‐invasive treatment for retrocaval ureter. Laparoscopic surgery could be the preferred treatment for retrocaval ureter.

A Rare Case of Right Retrocaval Ureter with Duplication of Infrarenal IVC.

Retrocaval ureter, also known as circumcaval ureter, is a rare congenital anomaly which commonly presents with loin pain in middle age group. Here, ureter passes between the inferior vena cava (IVC) and psoas muscle and gets compressed. Duplication of IVC is another rare congenital anomaly in the development of IVC. We present a case of a 49-year-old male who presented with loin pain and upon thorough investigation was found to have retrocaval ureter along with duplication of the infrarenal IVC. We bring forward this rare type of combination of two congenital malformations.

Retrocaval ureter: a rare congenital anomaly presenting as renal colic with hematuria

Retrocaval ureter, a congenital venous anomaly of inferior venacava development was first reported by Hochstetter in 1893. Though rare, it causes wide variety of symptoms ranging from asymptomatic individuals to end stage renal disease. Preoperative diagnosis is usually confirmed by imaging. In symptomatic cases, surgical intervention should be performed and renal function improves after operation. This article presents here, a case of retrocaval ureter presenting as renal colic with hematuria because of more degree of obstruction by inferior venacava with symptoms and signs, operative and perioperative management, as well as literature review of this rare clinically important entity.

Laparoscopic pyeloplasty: Technique and results in 80 consecutive patients

ObjectiveTo present our long-term results with the Anderson-Hynes laparoscopic pyeloplasty, performed by a single surgeon. Materials and methodsBetween August 1999 and December 2009, 79 patients (80 procedures) were operated for primary ureteropelvic junction obstruction. We use the Anderson-Hynes technique by a transperitoneal approach. Patients were evaluated with Ultrasound, Excretory urography and dynamic renal scintigraphy (Mag-3). The perioperative characteristics, complications and results were reviewed. ResultsWe performed 80 laparoscopic pyeloplasties in 79 patients. Mean operative time was 93.2min (60–180). Crossing vessels were found in 38 of 82 (46.3%) renal units. Kidney abnormalities occurred in 4 patients (1 double ureteropelvic system, one associated retrocaval ureter, 1 horseshoe kidney and one pelvic kidney). Complications occurred in 5 procedures (6.5%): an immediately postoperative bleeding (Clavien 3b), 1 cecal volvulus (Clavien 3b), 1 urosepsis (Clavien 4th) and 1 urinary fistula (Clavien 3a). In this series there was neither mortality nor conversion to open surgery. There was recurrence in 3 out of 80 patients (3.7%). They were resolved as follows: 1 percutaneous antegrade endopyelotomy, 1 secondary laparoscopic pyeloplasty and 1 robotic pyeloplasty. There was a 96.3% of primary overall success rate. ConclusionsOur results show that laparoscopic pyeloplasty compares favorably with the result achieved by open surgery. We believe that laparoscopic pyeloplasty is a good surgical alternative for the management of primary ureteropelvic junction obstruction.

Pieloplastia laparoscópica: técnica y resultados en 80 procedimientos consecutivos

ObjectiveTo present our long-term results with the Anderson-Hynes laparoscopic pyeloplasty, performed by a single surgeon. Material and methodsBetween August 1999 and December 2009, 79 patients (80 procedures) were operated for primary ureteropelvic junction obstruction. We use the Anderson-Hynes technique by a transperitoneal approach. Patients were evaluated with Ultrasound, Excretory urography and dynamic renal scintigraphy (Mag-3). The perioperative characteristics, complications and results were reviewed. ResultsWe performed 80 laparoscopic pyeloplasties in 79 patients. Mean operative time was 93.2minutes (60-180). Crossing vessels were found in 38 of 82 (46.3%) renal units. Kidney abnormalities occurred in 4 patients (1 double ureteropelvic system, one associated retrocaval ureter, 1 horseshoe kidney and one pelvic kidney). Complications occurred in 5 procedures (6.5%): an immediately postoperative bleeding (Clavien 3b), 1 cecal volvulus (Clavien 3b), 1 urosepsis (Clavien 4th) and 1 urinary fistula (Clavien 3a). In this series there was neither mortality nor conversion to open surgery There was recurrence in 3 out of 80 patients (3.7%). They were resolved as follows: 1 percutaneous antegrade endopyelotomy, 1 secondary laparoscopic pyeloplasty and 1 robotic pyeloplasty. There was a 96.3%. of primary overall success rate. ConclusionsOur results show that laparoscopic pyeloplasty compares favorably with the result achieved by open surgery. We believe that laparoscopic pyeloplasty is a good surgical alternative for the management of primary ureteropelvic junction obstruction.

Anomalous inferior vena cava associated with horseshoe kidney on multidetector computed tomography

We evaluated the prevalence of anomalous inferior vena cava (IVC) associated with 205 patients with horseshoe kidney (HSK) and 1990 patients without HSK on multidetector computed tomography and compared prevalence between both groups. We identified anatomical variations of the IVC in 8 patients (3.9%) with HSK (1 preisthmic IVC with retrocaval ureter, 4 double IVCs, 2 left IVCs, and 1 IVC with azygos continuation) and in 12 patients (0.6%) without HSK (8 double IVCs, 3 left IVCs, and 1 IVC with azygos continuation). Anomalous IVC was significantly more frequent in patients with HSK than those without it.

Robot-Assisted Surgical Management of Retrocaval Ureter and Renal Stone

Abstract Introduction: A retrocaval ureter (RCU) is a rare clinical entity that results from the abnormal persistence of the subcardinal vein. It is more common among males and usually presents in ...

Laparoscopic Reconstruction of Retrocaval Ureter Through Transperitoneal Approach in Different Scenarios

Abstract Introduction: Retrocaval ureter, also called circumcaval ureter, is a rare congenital anomaly with an incidence of 1 in 1100. The ureter becomes entrapped behind the inferior vena cava (IV...

Complementary value of the PET and CT in the correct evaluation of retrocaval ureter

Complementary value of the PET and CT in the correct evaluation of retrocaval ureter

Robotic uretero-ureterostomy of the retrocaval ureter without excision of the retrocaval segment

Robotic reconstruction of the retrocaval ureter is gaining momentum as the method of choice for surgically treating this rare condition. Maintaining the retrocaval ureteric segment further facilitates the procedure. We report a case of a 23-year-old man who underwent intraperitoneal robotic resection anastomosis and repositioning of the retrocaval ureter. We also discuss the advantages of this technique.

Laparoendoscopic Single-site Repair of Retrocaval Ureter Without any Special Devices

INTRODUCTION The retrocaval ureter is a rare congenital anomaly. The extrinsic compression may be responsible for obstruction and pain symptoms. The laparoscopic approach has been used with good results and less morbidity than the open surgery. Herein we describe a case of retrocaval ureter treated with LESS. To our knowledge, this represents the second such case reported in the literature, and the first without using any special devices, such as, single port or bended instruments. PRESENTATION Female, 23 years, complaining of right low back pain for a long time and recurrent urinary tract infection. Renal ultrasound demonstrated right-sided hydronephrosis and intravenous urography suggested the presence of retrocaval ureter. DTPA renal scintigraphy confirms delay in the elimination of contrast through the right kidney. A laparoendoscopic single-site repair was planned. The patient was placed in rightside-up modified flank position. A semicircular intra-umbilical incision was made and the conventional trocars (one 10 mm and two 5 mm) were inserted through the same incision on different points of the aponeurosis. The colon was dissected medially and the proximal ureter lateral to the vena cava was identified and dissected. An extra corporeal repair with Vycril 2-0 was used to facilitate the ureteral dissection and the anastomosis. A segment of ureter was ressected due to the tortuosity. Two 4-0 Vycril sutures were used to perform a running anastomosis. An ureteral stent was placed after the posterior layer on an antegrade fashion. A suction drain was left through the umbilicus. RESULTS The total operative time was 145 min. The blood loss was minimal. The patient was discharged on the third postoperative day and resumed total activity about 10 days after surgery. The double J was removed within 4 weeks. DISCUSSION Albeit technically challenging, LESS repair for retrocaval ureter might represent a feasible new treatment option for this rare anatomic anomaly. Special devices could help on the procedure, however they are not essencials.

Retrocaval ureter

Retrocaval ureter is a relatively rare anomaly that usually manifests in the third or the fourth decade of life. Its symptoms are because of ureteric obstruction, caused extrinsically by an abnormal inferior vena cava, intrinsically by ureteric hypoplasia, or both. Surgery is needed for symptomatic patients and involves transection and relocation of the ureter anterior to the inferior vena cava. We report here two neonates as might be very early diagnosed who needed surgery to correct a retrocaval ureter. Keywords : hydronephrosis, retrocaval ureter, neonates

A Rare Presentation of the Double Inferior Vena Cava with an Anomalous Retrocaval Right Ureter: Embryogenesis and Clinical Implications

On dissection of the abdomen of an adult male cadaver, in addition to the normal inferior vena cava on the right side, an unusual venous channel which connected the left renal vein with the left common iliac vein was found; (probably the left inferior vena cava). The left testicular and the left suprarenal veins were opening into the left renal vein as usual. Other than this, a retrocaval ureter was found on the right side. The works of previous authors have highlighted the incidence of a venacaval duplication and its surgical implications, but here, we are presenting a unique case of a double inferior vena cava with an anomalous retrocaval ureter. A conglomeration of such vascular malformations is of immense surgical importance, and it is indicative of a grossly defective angiogenesis. Keeping in mind the clinical relevance of the variations which were observed, an attempt was made to explain them in the light of the embryogenic development.

Retrocaval ureter - a case report

AbstractRetrocaval ureter is a rare congenital anomaly which has a incidence of occurence of one in 1500 live births. It is known to occur 2.8 times more commonly in males than females. While carrying out a study on congenital anomalies in urinary system in a collection of still born fetuses, a case of retrocaval ureter was noticed in a still born male foetus. In Retrocaval ureter, ureter is S shaped on the right side and a part of inferior vena cava is anterior to the proximal part of the ureter. Here the development of ureter is normal. Whereas the development of inferior vena cava is abnormal.

Transperitoneal Laparoscopic Repair of Retrocaval Ureter: Two Case Reports and A Review of Recent Literature

A retrocaval ureter is an unusual congenital anomaly that results in outer ureteral compression by the inferior vena cava. Open pyelopyelostomy or ureteroureterostomy procedures are done with good results. In the present era of minimal invasive access surgery, a laparoscopic technique is being used with the same good results with all advantages, like minimal analgesic, short hospital stay and with better cosmetic results.

Case Presentation of Preureteral Vena Cava and Review of the Literature

Retrocaval ureter, terms are anatomically descriptive but misleading in regard to development and results from altered vascular development. This anomaly is relatively uncommon, although it has clinical relevance. The ureter typically deviates medially behind the inferior vena cava, winding about and crossing in front of it from a medial to a lateral direction, to resume a normal course, distally, to the bladder. The renal pelvis and upper ureter typically appear elongated and dilated in a “J” or fishhook shape before passing behind the vena cava. Diagnoses were confirmed with intravenous urography and patient had an open surgical repair of the anomaly. The anomaly predominantly involves the right ureter, as was observed in these reported cases. Treatment is surgical allowing for correction of the anomaly with resolution of symptoms

Case Report of Left Retrocaval Ureter: Pre-Transplant CT Urographic Findings and Post-Transplant Outcomes

Case Report of Left Retrocaval Ureter: Pre-Transplant CT Urographic Findings and Post-Transplant Outcomes