Robot-assisted transperitoneal reconstruction of a retrocaval ureter: A report of two cases.

A retrocaval ureter (RCU) is a rare cause of congenital ureteral obstruction that often requires surgical repair. We report two cases of RCU in adults treated with robot-assisted laparoscopic surgery. In both cases, we performed robotic ureteroureterostomy with dissection of the entire length of the retrocaval portion of the right ureter without complications. In the second case, renal stone removal was simultaneously performed. The robot-assisted procedure we performed could be considered safe and feasible for the surgical repair of an RCU.

Retrocaval ureter: a rare cause of intermittent right flank pain in a 37 years old lady.

A 37 years old female presented with 6 months history of intermittent right flank pain. She was otherwise fit and had no other complaints. Her lab investigations were normal. Abdominal ultrsonography revealed moderate hydronephrosis and proximal hydroureter but no calculus. Retrograde ureteropyelography findings were consistent with the diagnosis of retrocaval ureter, a rare clinical condition. Surgical exploration confirmed the presence of right retrocaval ureter. The ureter was transected and transposed anterior to inferior vena cava and ureteropelvic anastomosis was performed. Postoperative recovery was uneventful.

Retrocaval ureter: a meta-analysis of prevalence.

INTRODUCTION: Retrocaval ureter is a congenital abnormality of the right ureter, which has been shown, in rare cases to cause clinical symptoms, mainly due to the development of ureterohydronephrosis. PURPOSE: The purpose of this article is to identify the prevalence of the retrocaval ureter, and to emphasize its clinical and surgical importance. DESIGN: A meta-analysis of prevalence, on cases obtained from PubMed, Web of Science, and Scopus databases. RESULTS: A total number of 13 studies contained data that allowed us to estimate the prevalence of the retrocaval ureter, which was identified overall in 9 cases, out of 18,493 subjects. The overall prevalence of retrocaval ureter was 0.13%, with a 95% confidence interval between 0.06 and 0.27%. There was no publication bias, all studies being under the funnel. CONCLUSIONS: The overall prevalence of retrocaval ureter is 0.13%. Even if this is obviously a rare condition, its presence must be suspected by practitioners, especially in the presence of urological symptoms without a clear cause.

[Ureteral Cancer Developing in Retrocaval Ureter : A Case Report].

Ureteral cancer in the retrocaval ureter is rare. We herein report a patient with this condition laparoscopically treated. A 69-year-old man was referred to us because of right ureteral cancer diagnosed during ureteroscopic surgery for a ureteral calculus. Histological diagnosis of the ureteroscopically biopsied material was non-invasive papillary urothelial carcinoma, low grade (G2). Computed tomography (CT) demonstrated a retrocaval ureter : a double J stent placed during ureteroscopy assisted the diagnosis. The patient underwent retroperitoneoscopic complete nephroureterectomy on the right side. Sufficient separation of the right ureter and the inferior vena cava under retroperitoneoscopic procedures facilitated en bloc extirpation of the kidney and ureter with a minimal lower abdominal incision. The surgical procedures for ureteral cancer in the retrocaval ureter, should be preoperatively considered with care.

[An unusual cause of acute pyelonephritis: the retrocaval ureter]. / Una causa non usuale di pielonefrite acuta: l'uretere retrocavale.

Retrocaval ureter is a rare congenital malformation in which the proximal right 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. This anatomical anomaly may be asymptomatic or manifest clinically, usually starting from the fourth decade of life, with flank pain, pyelonephritis, gross hematuria or other rarer signs. We describe the case of a young woman being hospitalized because of acute pyelonephritis; she had previously complained of flank pain associated with episodes of high fever. Computed tomography of the abdomen identified the malformation. The patient underwent surgical correction by laparoscopy and, at one year of follow-up, did not show any further clinical problem.

Right double inferior vena cava associated with retrocaval ureter: computed tomographic findings in two cases.

Two cases of right double inferior vena cava (RDIVC) were observed on computed tomography. In one case, the duplicated IVCs were both located to the right of the abdominal aorta and were nearly on the same coronal plane. In the other case, the right IVC showed partial duplication. The right ureter coursed posterior to the lateral IVC, then emerged between the duplicated IVC in both cases. The findings from the two cases presented in this report showed novel anatomical differences, likely attributable to different embryologic processes, as compared to previously reported cases of RDIVC.