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Case Reports
. 2007 Jun 8:7:8.
doi: 10.1186/1471-2490-7-8.

Prenatal diagnosis of a rare form of congenital mid-ureteral stricture: a case report and literature revisited

Milena Brugnara  1 , Mariangela Cecchetto, Riccardo Manfredi, Michele Zuffante, Vassilios Fanos, Angelo Pietrobelli, Marco Zaffanello
Affiliations
Case Reports

Prenatal diagnosis of a rare form of congenital mid-ureteral stricture: a case report and literature revisited

Milena Brugnara et al. BMC Urol. .

Abstract

Background: Congenital mid-ureteral stricture is a rare malformation of the ureter leading to prenatal and neonatal hydronephrosis. Site characterization of the narrowing is important to optimize the surgical approach to the newborn affected by hydronephrosis.

Case presentation: We report a female EM with a rare form of hydronephrosis, (i.e. mid-ureteral stricture) which was detected early during pregnancy by imaging techniques. During fetal life both conventional fetal Ultrasound and maternal Magnetic Resonance Imaging (MRI) were used to diagnose the obstruction. Magnetic Resonance pyelography and retrograde Ureteropyelography were performed after delivery and before surgical correction and confirmed the finding.Furthermore, we revisited the literature using online MEDLINE and EMBASE databases. The literature reported only a few cases of prenatal diagnosis of early onset mid-ureteral stricture.

Conclusion: Mid-ureteral stricture is a rare cause of prenatal hydronephrosis. The diagnosis should not be delayed in order to apply the appropriate surgical approach. As a result, we showed the usefulness of fetal MRI and postnatal Magnetic Resonance pyelography, in the event that radionuclide renography with Tc-MAG3 was less informative, to allow the detection of the site of ureteral narrowing. Intrasurgical retrograde ureteropyelography confirmed these findings.

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Figures

Figure 1
Figure 1
Fetal Magnetic Resonance Imaging (MRI) imaging: T2-weighted sequences. Axial Half Fourier Rapid Acquisition with Relaxation Enhancement (RARE) T2-weighted images shows dilation of the middle third of the ureter and coexist homolateral upstream hydronephrosis.
Figure 2
Figure 2
Magnetic Resonance Imaging (MRI) coronal T2-weighted images (Panel A), coronal MR urography (Panel B), and intrasurgical retrograde ureteropyelogram (Panel C). On coronal T2-weighted images and coronal MRI urography, can be depicted an obstruction of the middle third of the ureter, with upstream hydro-urethronephrosis, that was subsequently confirmed by intrasurgical retrograde ureteropyelogram (Panel C).
See this image and copyright information in PMC

References

    1. Pates JA, Dashe JS. Prenatal diagnosis and management of hydronephrosis. Early Hum Dev. 2006;82:3–8. doi: 10.1016/j.earlhumdev.2005.11.003. - DOI - PubMed
    1. Woodward M, Frank D. Postnatal management of antenatal hydronefrosis. BJU International. 2002;89:149–156. doi: 10.1046/j.1464-4096.2001.woodward.2578.x. - DOI - PubMed
    1. Shokeir AA, Nijman RJ. Antenatal hydronephrosis: changing concepts in diagnosis and subsequent management. BJU Int. 2000;85:987–994. doi: 10.1046/j.1464-410x.2000.00645.x. - DOI - PubMed
    1. Mandell J, Blyth BR, Peters CA, Retik AB, Estroff JA, Benacerraf BR. Structural genitourinary defects detected in uteri. Radiology. 1991;178:193–6. - PubMed
    1. Belarmino JM, Kogan BA. Management of neonatal hydronephrosis. Early Hum Dev. 2006;82:9–14. doi: 10.1016/j.earlhumdev.2005.11.004. - DOI - PubMed

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