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Lower ureteral obstruction due to a persistent umbilical artery
N P Gupta1, M Kumar, S C Karan
1Department of Urology, All India Institute of Medical Sciences, New Delhi, India. manalkumar@hotmail.com
Urologia Internationalis
|April 1, 2000
Summary
A persistent umbilical artery caused a 32-year-old woman's ureteric obstruction and infertility. Surgical resection of the aberrant vessel resolved the obstruction, offering a rare solution for adult female ureteric issues.
Area of Science:
- Urology
- Vascular Surgery
- Reproductive Medicine
Background:
- Ureteric obstruction can lead to significant health issues, including infertility.
- Aberrant or persistent vessels causing extrinsic ureteric obstruction are rarely reported, predominantly in pediatric cases.
- Diagnosis is often challenging and frequently requires surgical intervention.
Observation:
- A 32-year-old woman presented with primary infertility and recurrent left flank pain.
- Intravenous urography revealed left lower ureteric obstruction without a clear preoperative cause.
- Surgical exploration identified a persistent umbilical artery compressing the distal ureter.
Findings:
- The persistent umbilical artery, originating from the internal iliac artery, was identified as the cause of the ureteric narrowing.
- The aberrant vessel was surgically resected.
- The ureter was successfully reimplanted into the bladder, resolving the obstruction.
Implications:
- This case highlights a rare cause of ureteric obstruction and infertility in adult females.
- Successful surgical management demonstrates a viable treatment option for this uncommon condition.
- Increased awareness may improve diagnosis and timely intervention for similar cases.