Retrocaval ureter: a narrative review

Retrocaval ureter is a rare congenital anomaly resulting from the abnormal development of the inferior vena cava (IVC), where the ureter passes posteriorly and loops around the IVC. This review aims to provide a comprehensive overview of the etiology, classification, clinical presentation, diagnostic approaches, and management strategies for retrocaval ureter.

We performed a narrative, non-systematic literature review using PubMed, Google Scholar, Embase, and Web of Science for articles related to retrocaval ureter to perform a narrative review of the current literature on retrocaval ureter, including clinical case series, reviews, and surgical outcome studies. Emphasis was placed on diagnostic imaging, surgical techniques, and outcomes.

Retrocaval ureter has an estimated incidence of 1 in 1,000 births and is more frequently diagnosed in males. It is classified into two anatomical types, with Type 1 being more common and often associated with significant hydronephrosis. Advances in imaging, including computed tomography (CT) urography and magnetic resonance (MR) urography, have improved diagnostic accuracy. The management of retrocaval ureter varies depending on the severity of symptoms, but surgical correction, primarily through minimally invasive techniques like laparoscopic or robotic ureteroureterostomy, is the treatment of choice in symptomatic patients. Minimally invasive surgery offers reduced recovery time and excellent outcomes.

Retrocaval ureter is a rare but significant condition that can lead to ureteral obstruction and hydronephrosis. Early diagnosis through modern imaging and prompt surgical intervention in symptomatic cases can prevent long-term renal damage. Minimally invasive techniques have emerged as the gold standard for surgical management, offering favorable outcomes with minimal complications.