Transperitoneal laparoscopic ureteropyeloplasty of retrocaval ureter: Single surgeon experience and review of literature

Abstract

Introduction: Retrocaval ureter (RCU) is a rare congenital abnormality, secondary to anomalous development of inferior vena cava (IVC) presenting as ipsilateral obstruction needing surgical intervention. The aim of this article is to present surgical techniques and outcome of transperitoneal laparoscopic ureteropyeloplasty in patients with RCU treated by a single surgeon at a tertiary care center and with review of literature. Material and Methods:We conducted a retrospective, institutional review board approved chart review of patients who underwent transperitoneal laparoscopic ureteropyeloplasty for RCU at our unit between January 2010 and December 2020. A total of 10 patients were identified. Preoperative evaluation involved a computed tomography-intravenous urography in addition to the conventional evaluation. All the patients underwent dismembered transperitoneal laparoscopic ureteropyeloplasty over a Double J stent. Data analyzed included the demographic profile, operative time difficulty if any, postoperative, intraoperative complications and functional outcome.Results: All cases were completed laparoscopically and no open conversion was required. Average operating time was 96.6 minutes ± 8.16. Average blood loss was 71 ± 14.49 mL with an analgesia requirement of 115 ± 33.74 mg. One patient developed postoperative urinary leak and responded to percutaneous nephrostomy drainage. Patients were followed up for 3 to 12 months with a serial ultrasound and a follow-up diethylene-triamine-penta-acetic acid renal scan at 3 months to rule out any anastomotic site obstruction. Conclusion: Transperitoneal laparoscopic ureteropyeloplasty for RCU was associated with minimal morbidity and good outcomes.

Retrocaval Ureter With Ureteric Stones: A Case Report

“…Surgery is essential to maintain kidney function when the urinary tract is completely blocked. Surgical treatment options for the retrocaval ureter include laparoscopic, robotic, or open surgery [16][17][18]. Although open surgery has been the gold standard for the treatment of retrocaval ureter [7], laparoscopic surgery has been used to treat this condition [19].…”

Experience in Retrocaval Ureter at Saint Paul’s Hospital Millennium Medical College: A Case Series

“…However, there are some rare conditions where it may be found on the left side, like in cases of situs inversus, duplication of the IVC, or persistent left subcardinal vein. 7 Majorities of patients with type 2 retrocaval ureter are asymptomatic in their early lives and may seek help because of https://doi.org/10.2147/RRU.S419718 Anomalies related to RCU can occur in up to 21% of the patients. Cardiovascular abnormalities, genitourinary anomalies (such as horseshoe kidney, missing or ectopic opposite kidney, and agenesis of vasor uterus), Turner syndrome, and imperforated anus are among these congenital anomalies.…”

“…However, there are some rare conditions where it may be found on the left side, like in cases of situs inversus, duplication of the IVC, or persistent left subcardinal vein. 7 Majorities of patients with type 2 retrocaval ureter are asymptomatic in their early lives and may seek help because of right-flank pain with urinary tract infections and haematuria in the third or the fourth decade. 8 Our index cases presented with a short duration of right-side flank pain.…”

Reconstrução de ureter retrocava: relato de caso e descrição cirúrgica

“…Outro achado recorrente é dor e pielonefrite de repetição. [3][4][5]7] O tratamento é individualizado, sendo possível realizar tratamento clínico em casos de graus menores de obstrução ureteral e hidronefrose. O tratamento cirúrgico é feito em casos de dor significativa, hidronefrose severa e infecções do trato urinário de repetição, com a cirurgia de escolha sendo a pieloplastia, na qual o ureter é transposto anteriormente à veia cava.…”