A case report of minimally invasive management of congenital retrocaval ureter

Retrocaval ureter (RU) is a rare congenital malformation where the ureteric pathway is altered, passing posteriorly around the inferior vena cava (IVC). Occasionally, this leads to the IVC compressing the ureter, resulting in obstruction. In this report, we discuss a male who presented with severe right-sided flank pain and was otherwise well with no significant medical, urological, or birth history. Initial imaging revealed severe right-sided hydroureter with distinct obstruction point, and likely RU. Anecdotal and small centre cases of acute management and laparoscopic RU repair were reviewed. Initial management focused on pain control requiring a nephrostomy with subsequent transperitoneal laparoscopic dissection and repair. Operative time was 138 min with 50 mL blood loss. Post-operatively the patient recovered well and was symptom free at 6 month follow up ultrasound. Similarly, most reviewed cases chose a trans-peritoneal laparoscopic approach with good outcomes.