case_images: PMC6551479_01
case_images: Renal ultrasound of patient 1 showing severe right-sided hydronephrosis.
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case_images: PMC6551479_01_gr1.jpg
case_images: fig0005
case_images: Renal ultrasound showed severe right-sided hydronephrosis (Fig. 1) and computed tomography scan suggested the presence of a RCU (Fig. 2).
case_images: KUB of patient 1 showing the double J stent that takes the S shape of the ureter.
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case_images: PMC6551479_01_gr3.jpg
case_images: fig0015
case_images: The patient was treated with intravenous antibiotics and drainage of the right kidney by a double J stent (Fig. 3) with retrograde ureteropyelography that confirmed the diagnosis of retrocaval ureter (Fig. 4), antibiotic treatment continued for 2 weeks orally, and laparoscopic repair of retrocaval ureter was planned after sterilization of the urine.
case_images: PMC6551479_02
case_images: Renal ultrasound of patient 2 showing severe right-sided hydronephrosis.
case_images: gr5.jpg
case_images: PMC6551479_02_gr5.jpg
case_images: fig0025
case_images: Renal ultrasound demonstrated sever right-sided hydronephrosis (Fig. 5) and computed tomography scan suggested the presence of a retrocaval ureter (Fig. 6), Serum testing demonstrated preserved renal function, and a laparoscopic repair of retrocaval ureter was planned, with a right retrograde ureteropyelography (Fig. 7), done just before the surgery for a retrograde double J stent placement (Fig. 8), and confirmed the diagnosis of retrocaval ureter.
case_images: Right retrograde ureteropyelography of patient 2 showing the S shape of the ureter.
case_images: gr7.jpg
case_images: PMC6551479_02_gr7.jpg
case_images: fig0035
case_images: Renal ultrasound demonstrated sever right-sided hydronephrosis (Fig. 5) and computed tomography scan suggested the presence of a retrocaval ureter (Fig. 6), Serum testing demonstrated preserved renal function, and a laparoscopic repair of retrocaval ureter was planned, with a right retrograde ureteropyelography (Fig. 7), done just before the surgery for a retrograde double J stent placement (Fig. 8), and confirmed the diagnosis of retrocaval ureter.
case_images: Trocars' positions (same laparoscopic technique for the two patients).
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case_images: PMC6551479_02_gr9.jpg
case_images: fig0045
case_images: The 5-mm fourth trocar was placed for traction on midaxillary line at the level of the umbilicus (Fig. 9).
case_images: Dilated proximal renal pelvis and ureter were found and separated from the adjacent tissue by a blunt and sharp dissection.
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case_images: PMC6551479_02_gr10.jpg
case_images: fig0050
case_images: Toldt line, the dilated proximal renal pelvis and ureter were found and separated from the adjacent tissue by a blunt and sharp dissection (Fig. 10). Traction of the proximal ureter by a stich of the renal pelvis through the abdominal wall, helped to identify the distal ureteral segment which was released without damaging the periureteral soft tissue.
case_images: Transection at the ureteropelvic junction.
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case_images: PMC6551479_02_gr11.jpg
case_images: fig0055
case_images: After the complete release of the ureteral segment beneath the inferior vena cava, the dilated renal pelvis was transected at the ureteropelvic junction (Fig. 11).
case_images: Persistence of the posterior cardinal vein ventral to the ureter entrapping it.
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case_images: fig0060
case_images: Because of the persistence of the posterior cardinal vein that is located ventral to the ureter, the ureter will become entrapped behind the vein (Fig. 12).
case_images: RCU Type I (low loop) with the dilated proximal ureter assuming the shape of a reverse "J".
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case_images: PMC6551479_02_gr13.jpg
case_images: fig0065
case_images: Type I (low loop) (Fig. 13) is the most common, with the dilated proximal ureter assuming the shape of a reverse "J".