Clinical case:

A 49-year-old man presented with intermittent colicky pain in the right renal fossa that radiated to the right flank, accompanied with nausea and vomiting on numerous occasions. Retrocaval ureter was diagnosed through computed tomography urography and the patient was admitted to the urology service. Right dismembered ureteroureterostomy was performed with the open lumbotomy approach, finding dilatation of the renal pelvis and upper third of the right ureter and the course of the ureteral tract posterior to the inferior vena cava. The patient had satisfactory postoperative progression.

Relevance:

Retrocaval ureter is a rare anomaly, in which the ureter passes behind the inferior vena cava. Only about 200 cases have been reported worldwide.

Clinical implications:

The pathology presents in 70% of cases with right flank pain that can be dull and persistent or manifest as frank renal colic. Computed tomography urography is the main diagnostic method and treatment is almost always surgical.

Conclusion:

Patients with retrocaval ureter may or may not require surgical treatment, depending on the symptomatology. When surgery is needed, it can be open or minimally invasive, given that a surgical gold standard has yet to be described.

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