case_images: PMC10963103_01
case_images: Abdominopelvic computerized tomography (CT). (a, b) Coronal and axial images reveal atrophic right kidney with cystic right seminal vesicle.
case_images: CRIU2024-9432939.001.jpg
case_images: PMC10963103_01_CRIU2024-9432939.001.jpg
case_images: fig1
case_images: Computed tomography (CT) urogram obtained at that time revealed a normal left-sided collecting system and a congenitally atrophic right kidney with ipsilateral ectopic ureter implanting into a dilated cystic seminal vesicle (Figure 1).
case_images: Retrograde ureterogram imaging showing (a) a rigid ureteroscope in the right seminal vesicle that is filled with contrast and (b) a dilated distal right ureter coming off the seminal vesicle.
case_images: CRIU2024-9432939.002.jpg
case_images: PMC10963103_01_CRIU2024-9432939.002.jpg
case_images: fig2
case_images: A retrograde pyelogram (Figure 2) was then performed showing a notably dilated right ureter.
case_images: Port placements for robotic-assisted nephroureterectomy.
case_images: CRIU2024-9432939.003.jpg
case_images: PMC10963103_01_CRIU2024-9432939.003.jpg
case_images: fig3
case_images: We placed 4 robotic arms in a modified diamond configuration with a 10/12 AirSeal assist superior to the umbilicus and the robot was docked (Figure 3).
case_images: The ectopic ureter was identified implanting into the seminal vesicle (a). The ureter was transected at the level of its insertion using Hem-o-lok clips (b). The renal hilum was then identified (c). The atrophic kidney was identified, and a complete nephrectomy was performed (d).
case_images: CRIU2024-9432939.004.jpg
case_images: PMC10963103_01_CRIU2024-9432939.004.jpg
case_images: fig4
case_images: We identified the ureter inserted into the seminal vesicle (Figure 4(a)). We were able to dissect the ureter to its insertion and then transected the ectopic ureter at the level of the seminal vesicle using Hem-o-Lok clips (Figure 4(b)). Thus, by dissecting around the adrenal gland in the lower pole portion, we were able to identify the area of the renal hilum (Figure 4(c)). At this point in time, the kidney was freely detached and we had thus performed a complete nephrectomy with total ureterectomy (Figure 4(d)).
case_images: Gross specimen of the right atrophic kidney and ureter.
case_images: CRIU2024-9432939.005.jpg
case_images: PMC10963103_01_CRIU2024-9432939.005.jpg
case_images: fig5
case_images: The final pathology showed a benign ureter and atrophic kidney (Figure 5).