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Related Experiment Videos

Congenital mid ureteral strictures.

Andrew H Hwang1, Irene M McAleer, Ellen Shapiro

  • 1Division of Urology, Childrens Hospital Los Angeles, Los Angeles, California 90027, USA. ahwang@chla.usc.edu

The Journal of Urology
|October 12, 2005
PubMed
Summary

Congenital mid ureteral stricture is a rare condition. Retrograde pyelography is crucial for accurately diagnosing ureteral narrowing, especially when other imaging modalities are inconclusive.

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Area of Science:

  • Pediatric Urology
  • Congenital Abnormalities
  • Urinary Tract Imaging

Background:

  • Congenital mid ureteral stricture is an uncommon cause of urinary obstruction in children.
  • This condition often presents with prenatal hydronephrosis or symptoms in older children, mimicking other ureteral obstructive entities.

Purpose of the Study:

  • To report on 7 cases of congenital mid ureteral stricture.
  • To discuss the diagnostic challenges and surgical management strategies for this rare condition.

Main Methods:

  • Retrospective review of medical records and imaging studies of 7 children with mid ureteral strictures.
  • Utilized renal ultrasound, voiding cystourethrography, radionuclide renography, computerized tomography, and retrograde pyelography for diagnosis.
  • Pathological examination of surgical specimens was performed.

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Main Results:

  • Prenatal hydronephrosis was the most frequent presentation; no urinary tract infections or vesicoureteral reflux were observed.
  • Initial imaging studies preoperatively misidentified the obstruction site in 6 out of 7 patients.
  • Retrograde pyelography accurately diagnosed mid ureteral narrowing in all cases.
  • Six patients underwent successful ureteroureterostomy; two patients required nephrectomy due to kidney nonfunction or end-stage disease.

Conclusions:

  • Congenital mid ureteral stricture is rare and challenging to diagnose.
  • Renal ultrasound and radionuclide renography are insufficient for reliably localizing obstruction.
  • Retrograde pyelography is a vital tool for accurate diagnosis of mid ureteral narrowing during surgical correction.