Spectrum of presentation and management of retrocaval ureter: a 10-year single centre experience

Abstract

Retrocaval ureter is a rare congenital abnormality with an incidence of 0.06-0.17%. With the frequent use of radiological imaging in modern practice, there has been an increase in the identification as well as evolution in the management options for these cases. We present a series of 18 cases of retrocaval ureter managed at our institute from August 2015 to May 2025. The initial evaluation included routine blood investigations and ultrasound KUB followed by CT scan, IVU and RGP for confirmation. This case series aims to highlight the spectrum of presentation of retrocaval ureter that we encountered and the management option chosen. In our study, there were 17 cases of Type 1 retrocaval ureter and one case of Type 2 retrocaval ureter. 14 cases presented with flank pain, 3 cases with urinary tract infection and 1 case were an incidental finding. One patient had an associated renal pelvic calculus and 1 patient had a poorly functioning right kidney. One patient presented with a broken forgotten DJ stent in situ placed initially in view of recurrent urinary infections. In our study, 1 patient had left renal agenesis and 1 patient was a known case of ventricular septal defect. Retrocaval ureter, being a rare entity, has been reported sporadically over decades. The existing case series report a few numbers of cases or dwell on the traditional management done with the increasing trend towards minimal invasive approach. In our study, we aim to highlight the varied presentations of retrocaval ureter that we encountered in our institute, along with the management tailored accordingly. Retrocaval ureter is a rare clinical entity. With modern diagnostic tools, there is an increasing chance of early diagnosis, thus enabling us to safeguard the renal function with prompt intervention.