Right double inferior vena cava with obstructed retrocaval ureter is an extremely rare anomaly with only a few reported cases in the literature. To the best of our knowledge, this is the first case report describing ureteric repair by use of a single-incision laparoscopic technique. In addition, this report addresses the underlying surgical challenges of this repair and provides a brief review of the embryology of this anomaly. The "Santosh Postgraduate Institute ureteric tacking fixation technique" provides ease of end-to-end uretero-ureteric anastomosis in a single-incision laparoscopic surgery.
Humans ; Intraoperative Care/methods ; Intraoperative Complications/*prevention & control ; Laparoscopy/methods ; Magnetic Resonance Imaging ; Male ; *Retrocaval Ureter/diagnosis/physiopathology/surgery ; Treatment Outcome ; Urography/methods ; Urologic Surgical Procedures/*methods ; *Vena Cava, Inferior/abnormalities/surgery ; Young Adult

OBJECTIVETo analyze the results of transperitoneal and retroperitoneal laparoscopic ureteroureterostomy procedure in the treatment of patients with retrocaval ureter.

METHODSFrom May 2004 to December 2012, 18 patients including 12 male and 6 female patients were operated for retrocaval ureter, the average age was (37 ± 10) years (range 17-55 years). Eight patients underwent transperitoneal laparoscopic ureteroureterostomy (transperitoneal laparoscopic group), and the other 10 patients' laparoscopic procedure were performed via retroperitoneal approach(retroperitoneal laparoscopic group). These patients' records were retrospectively analyzed for perioperative characteristics, complications and follow-up results. A two-tailed Student's t-test was used to compare perioperative data between the two groups.

RESULTSTechnical success was acquired in all 18 laparoscopic procedures. Mean operative time of transperitoneal and retroperitoneal laparoscopic group was (85 ± 20) minutes (60-130 minutes) and (98 ± 30) minutes (70-180 minutes) , respectively. There was no difference in operation time between the two groups (t = 1.03, P > 0.05). The blood loss was less than 50 ml in all the patients. Comparison of anal exhaust time between the two groups showed no statistic difference (t = 0.16, P > 0.05). No perioperative complication was observed. Intravenous pyelography or CT urography 3 months after the operation revealed a widely patent anastomosis with considerable improvement in hydronephrosis in all patients. There was no recurrence at a mean follow up of (40 ± 24) months (range 12-115 months).

CONCLUSIONBoth transperitoneal and retroperitoneal laparoscopic ureteroureterostomy are effective and minimally invasive surgical alternative for the management of retrocaval ureter.

Adolescent ; Adult ; Female ; Follow-Up Studies ; Humans ; Laparoscopy ; methods ; Male ; Middle Aged ; Retrocaval Ureter ; surgery ; Retrospective Studies ; Treatment Outcome ; Young Adult

Retrocaval ureter is a relatively rare anomaly where ureteric obstruction may occur as a result of ureter passes behind the inferior vena cava (IVC), hence, compressing it between the IVC and the vertebrae. We report 2 cases of retrocaval ureter with different presentations. One patient was managed surgically with minimally invasive approach and the other was managed conservatively.
Retrocaval Ureter

Adult ; Humans ; Laparoscopy ; methods ; Male ; Retrocaval Ureter ; surgery ; Ureterostomy ; methods ; Young Adult

Retrocaval ureter is a rare congenital anomaly that causes symptomatic hydronephrosis. Despite difficulties in the intracorporeal suturing, a retrocaval ureter is thought to be a good candidate for laparoscopic surgery, especially from the cosmesis. Laparoscopic ureteroureterostomy has advantages compared to conventional open surgery in terms of less pain, decreased blood loss, smaller operative wound and shorter hospital stay. Herein, we report our initial experience of laparoscopic ureteroureterostomy in a patient with a retrocaval ureter.
Humans ; Hydronephrosis ; Laparoscopy ; Length of Stay ; Retrocaval Ureter* ; Sutures ; Ureter ; Wounds and Injuries

Circumcaval ureter is one of the congenital anomaly in which aberrant development of the inferior vena cava (IVC) causes compression of the deviated ureter medially behind the IVC. The incidence is approximately one in 1500 cadavers and is three to four times more common in male. Although the lesion is congenital, symptoms attributable to this anomaly usually appear in young adulthood. This is a case of 17-year-old spinal cord injured man with a circumcaval ureter who was diagnosed as right hydronephrosis by routine evaluation for neurogenic bladder, incidentally. Suprapubic cystostomy was done for prevention of further urologic complication and the severity of hydronephrosis was not aggravated in follow up studies after 6 months. We suggest early routine evaluation for neurogenic bladder is very important for prevention of developing urologic complication caused by congenital urologic anomaly in the patients with spinal cord injury.
Adolescent ; Cadaver ; Cystostomy ; Follow-Up Studies ; Humans ; Hydronephrosis* ; Incidence ; Male ; Retrocaval Ureter* ; Spinal Cord Injuries ; Spinal Cord* ; Ureter ; Urinary Bladder, Neurogenic ; Vena Cava, Inferior

Retrocaval ureter is a congenital venous anomaly, in which the ureter passes behind and is compassed by inferior vena cava. We experienced a case of multiple urothelial cell carcinoma in retrocaval ureter in 68 years old male. He was treated with transurethral resection of bladder tumor and right nephroureterectomy with bladder cuff excision.
Aged ; Carcinoma, Transitional Cell ; Humans ; Male ; Retrocaval Ureter* ; Ureter ; Urinary Bladder ; Urinary Bladder Neoplasms ; Vena Cava, Inferior

Retrocaval ureter is a rare congenital anomaly. We experienced a case of retrocaval ureter with double inferior vena cava and with intermittent right flank pain in 54 years old female. We performed IVU, RGP, Venacavogram, MRI, and diuretic DTPA renal scan. MRI is the best single study to delineate the anatomy clearly and noninvasively. She was treated with conservative treatment.
Female ; Flank Pain ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Pentetic Acid ; Retrocaval Ureter* ; Vena Cava, Inferior*

Retrocaval ureter is a congenital venous anomaly, in which the ureter passes behind and is compressed by inferior vena cava. We present 7 cases of retrocaval ureter who admitted to our hospital from March 1984 to February 1994. Age of patients ranged from 23 to 65 years, a mean 37 years. The anomaly occurred 3 in male and 4 cases in female. Initial symptoms included flank pain in 5(71%) and symptom-free in 2 cases(29%). The patients were classified into type I(low loop, 5 cases) and type II(high loop, 2 cases) by Kenawi's classification depending on the level of uretero-caval cross over. Of 5 cases of type I retrocaval ureter 4 were underwent spatulated end-to-end ureteral anastomosis with resection of retrocaval ureteral segment, 1 was underwent nephrectomy. 2 cases of type II were treated conservatively. All of cases underwent spatulated end-to-end ureteral anastomosis showed regression of hydronephrosis and satisfactory drainage of the kidney in postoperative IVU. The pathologic findings of the resected ureteral segments showed fibrosis and chronic inflammatory cell infiltration in 3 and normal findings in 2 cases in H & E stain. But in the trichrome stain, fibrous replacement of ureteral muscle layers were demonstrated in all of cases. Guideline for treatment of retrocaval ureter may be based on specific radiographic criteria Resection of the retrocaval segment and spatulated end-to-end anastomosis may be required in the cases of the type I retrocaval ureter.
Classification ; Drainage ; Female ; Fibrosis ; Flank Pain ; Humans ; Hydronephrosis ; Kidney ; Male ; Nephrectomy ; Retrocaval Ureter* ; Ureter ; Vena Cava, Inferior

Retrocaval ureter or circumcaval ureter is a congenital anomaly of vascular system commonly causing ureteric obstruction. We present a case of right retrocaval ureter with right renal stone in a 42 year old man and a case with right flank dull pain and hypertension in 40 year old female. They were treated with ureteral end to end anastomosis with double-J stent.
Adult ; Female ; Humans ; Hypertension ; Retrocaval Ureter* ; Stents ; Ureter