Retrocaval Ureter: A Report of Two Cases

Abstract

ETROCAVAL ureter is a rare anomaly R based on abnormal development of the inferior vena cava, as a result of which the right ureter passes medially under the vessel and then crosses laterally over it, to pursue its course into the pelvis. Other names for this condition are post-caval ureter, circumcaval ureter and pre-ureteric vena cava. The last title is preferred by some authors indicating, as it does, the aetiology of the condition. The condition has usually been considered to be invariably right sided but Brooks (1962) has described a case of left-sided retrocaval ureter associated with transposition of the viscera.The condition was first described by Hochstetter in 1893, his and other early cases being found at post-mortem examinations. Kimbrough (1935) made the first diagnosis at operation and performed a successful plastic repair. The first correct pre-operative diagnosis was made by Harrill (1940) and since then correctly diagnosed and successfully treated cases have been reported in increasing numbers and in a review of the literature in 1960, Rowland, Bunts and Iwano collected over 90 cases.The present 2 cases, found during postmortem dissections, merit description, one occurring in the oldest known patient to have such an anomaly, while the second case is the In 1947, A. C. Telfer described 2 cases of preureteric vena cava in the Proc. Urol. Sac. Aust., a journal of limited circulation, and these have not been included in the series of collected cases. These occurred in 2 female patients, aged 30 and 33, were aasociated with right renal symptoms and with right hydronephrosis and hydroureter, ending at the level of the third lumbar vertebra in one case and just above the common iliac vein in the second case, in which other anomalous veins were present. In each case the diagnosis was made at operation and nephrectomy was performed because of the difficulty of correction of the anomaly.fifth recorded example of the rare variation of the condition associated with bilateral venae cavae. Case 1R.C.T., an emaciated man aged 85, was admitted to hospital in 1950, suffering from clot retention.For three months he had noticed heavy painless haematuria with frequency and nocturia. Over the . previous four months his general health had deteriorated rapidly, with severe loss of weight.On admission he was suffering from acute blood loss and transfusion was begun. A hard mass was palpable on rectal examination above the prostate.A large amount of blood clot was evacuated from the bladder but this had no effect on the bleeding, which continued unabated. Under local anaesthesia suprapubic cystotomy was performed and the cause of the bleeding found to be an extensive ulcerating carcinoma of the bladder, extending from the left side of the bladder across to the right ureteric orifice, involving the rectum and the wall of the pelvis on the left side. Reasonable haemostasis was secured by removing most of the protuberant growth with a loop electrode with heavy coagulation of the deeper layers. There was no further blood los...

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“…A portion of the proximal ureter becomes entrapped, causing the ureter to coil around the IVC. As a result, other names for it include preureteral vena cava and circumcaval ureter [2].…”

Management of a rare symptomatic retrocaval ureter: a case report with review of literature

“…The standard repair is open surgical pyelopyelostomy or ureteroureterostomy. Repair usually includes resection of redundant retrocaval ureteral segment, anteposition, and anastomosis [ 4 ]. In our case, we also followed the same surgical principles to preserve the renal function.…”

Retrocaval Ureter: A Case Report

“…Typical 'fish hook' or 'J'-or 'S'-shaped deformities in the proximal dilated ureter are appear in intravenous urogram. CT scan is the goldstandered investigation in diagnosis of RCU [4].…”

“…Surgical rapier was important specially on patients whose renal functions start to deteriorate. There is a many type for surgical technique but open surgical pyelopylostomy is agoldstander technique [4]. N this case and under possible aseptic conditions by general antithesia we put the patient in flank position and by open surgical technique a pyelopylotomy wad preformed.…”