Conservative management of retrocaval Ureter: A case series

Abstract

Introduction: Retrocaval ureter is a rare congenital anomaly with the ureter passage posterior to the inferior vena cava. Surgical repair is suggested for patients with significant functional obstruction. However, there is little literature to suggest the management of asymptomatic patients.

Case presentation: Case 1 patient is a 29 year-old Indonesian man and case 2 patient is a 41 year-old Malay man. Both patients were asymptomatic and well.

Discussion: This report is the short follow-up, therefore making it impossible to elucidate the natural history of uncorrected retrocaval ureters.

Conclusion: At 8 month and 6 month respectively, they remained well without symptoms. Our report suggests that immediate surgical repair is not always needed. Longer follow-up with larger patient population is needed to formally elucidate the natural history of this uncommon condition.

Keywords: Circumcaval ureter; Conservative management; Preureteral vena cava; Retrocaval ureter.

Fig. 1

Coronal and sagittal cuts of CT scan showing retrocaval ureter; the CT scan images show dilated right renal pelvis and ureter which passes behind the inferior vena cava.

Fig. 2

MAG-3 renogram demonstrating no obstruction to urinary excretion; The MAG-3 renogram demonstrates good clearance of contrast with no obstruction, indicating good function of both kidneys. The differential function of the left and right kidney is 47.6% and 52.4% respectively.