Hypothesis on etiopathogenesis, congenital or acquired, of an imperforate distal ureter: a case report

Abstract

Introduction: Ureteral atresia is a rare disease usually associated with a non-functioning kidney. Its association with other urinary anomalies is rare.

Case presentation: In this study we discuss the possibility of congenital or acquired etiology of a right imperforate distal ureter. Here we report the case of 11-month-old white boy with a right ureteropelvic junction obstruction. He underwent a right pyeloplasty when he was 11-months old, and 3 weeks after surgery a cystoscopy was performed. Two months after the first operation, he underwent a right ureteral meatoplasty and a new pyeloplasty.

Conclusions: To the best of our knowledge, few cases of imperforate distal ureter have been described in the literature. The suspicion of a non-patent terminal ureter, occurring during upper urinary tract surgery, must be intraoperatively clarified to preserve the renal function and to avoid more complex surgical approaches.

Fig. 1

Longitudinal ultrasound image of right renal pelvis

Fig. 2

Attempt of catheterization of presumed meatus (arrow) with ureteral stent (US)

Fig. 3

Appearance of the right ureteral meatus after JJ stent removal

Fig. 4

Ultrasound image 30 months after surgery