Congenital Mid Ureteral Strictures

Abstract

Congenital mid ureteral stricture is rare. Renal ultrasound and radionuclide renography alone do not reliably demonstrate the site of obstruction. Retrograde pyelography at the time of surgical correction of presumed ureteral obstruction is an important adjunct for correctly identifying the site of narrowing in the affected ureteral segment, unless the ureter has been imaged with another modality.

An unusual case of bilateral primitive obstructed megaureters due to ureteral valves presenting with anuria at the age of 1 month

“…Muscularization of the ureteral tube begins at the 12th week of gestation and continues throughout pregnancy. The pathophysiology of these lesions may be due to a vascular compression that might interfere with the muscularization process, leading to an incompletely formed segment of ureteral mucosa [10][11][12]. These vessels, however, are not always demonstrable; it is postulated that they disappear as part of the embryological developmental process, leaving behind the stricture [12].…”

“…The ureteral valves must be differentiated from congenital ureteral strictures, which are rare, usually found in early adulthood, but can be often revealed by hydronephrosis on antenatal ultrasound [9,10]. They correspond to a segmental ureteral fibrosis, usually associated to a smooth muscle hypoplasia.…”

“…The ureteral lumen is usually narrow but sometimes can be of normal caliber. The stricture can be localized anywhere in the ureter [10]. Muscularization of the ureteral tube begins at the 12th week of gestation and continues throughout pregnancy.…”

Lactante con estenosis de uréter medio congénito tratado endourológicamente

“…Los hallazgos anatomopatoló gicos má s frecuente son la hiperplasia asimétrica de la capa muscular del uréter con dilatació n de estructuras proximales, siendo raro encontrar fibrosis de las distintas capas periuroteliales. La longitud del segmento anó malo es siempre limitada y menor de 2 cm 2,4 . Encontramos en todos estos hallazgos justificació n para intentar realizar un tratamiento endouroló gico, ya que no existen compresió n extrínseca del uréter ni fibrosis que vayan a implicar una alteració n del crecimiento del segmento ureteral en el futuro.…”

Laparoscopic repair of congenital midureteric strictures in infants and children

“…It is estimated that about 4-5% of congenital ureteral obstructions are located between the two ends of the ureter 1,2 . Most congenital midureteric strictures (CMUS) are now diagnosed as antenatal hydronephrosis (HDN) [3][4][5][6] . Because of its rarity, there are no clear guidelines on the management of CMUS.…”