Ureteroscopy as a diagnostic tool with potential therapeutic impact in nutcracker syndrome–related hematuria: A case report

Nutcracker Syndrome (NCS) involves entrapment of the left renal vein (LVR), between the abdominal aorta and superior mesenteric artery. Often presenting with hematuria, flank pain. NCS diagnosis remains challenging due to lack of standardized criterion. A 27-year-old female with chronic painless hematuria. Imaging disclosed LRV compression, ureteroscopy demonstrated blood efflux from the left ureter and a clot in the proximal left ureter. Otherwise, normal findings, all laboratory testing were negative. With resolution of symptoms in one year follow-up. Although not a standard NCS diagnostic tool, ureteroscopy proved valuable in localizing pathology and may offer therapeutic benefit, which warrant further research.