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Laparoscopic Retroperitoneal Repair of a Retrocaval Ureter: A Case Report and Video Demonstration
Mohammed Alshehri1, Ebtesam Almajed2, Khadijah Eid3
1Department of Urology, King Abdullah Bin Abdulaziz University Hospital, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia, pnu.edu.sa.
Background:
Retrocaval ureter is an uncommon congenital condition caused by abnormal development of the inferior vena cava. The resulting posterior displacement of the ureter may produce compression, impaired urinary drainage, and hydronephrosis.
Case Presentation:
A 35-year-old man was referred following the detection of a right-sided Type I retrocaval ureter during evaluation of right renal colic. Laboratory investigations and physical examination were unremarkable. Computed tomography urography and retrograde pyelography demonstrated the characteristic abnormal ureteral course with associated proximal obstruction. The patient underwent laparoscopic retroperitoneal mobilization, transposition, and reconstruction of the ureter. The operative steps are presented in an accompanying video. Recovery was uncomplicated, and follow-up imaging demonstrated resolution of the obstruction.
Conclusion:
Laparoscopic retroperitoneal reconstruction provides direct access to the affected ureter while avoiding entry into the peritoneal cavity. In appropriately selected patients and experienced hands, it represents an effective minimally invasive option for the treatment of retrocaval ureter.