Koichi Kodama, MD, Yasukazu Takase, MD, Isamu Motoi, MD
Department of Urology, Toyama City Hospital, Toyama, Japan (all authors).
Introduction: Retroperitoneoscopic laparoendoscopic single-site surgery for congenital midureteral stricture was performed in a nulliparous girl with contralateral multicystic dysplastic kidney.
Case Description: The patient presented with a 4-year history of intermittent right flank pain and 3 episodes of right acute pyelonephritis. A right-sided retrograde ureteropyelogram showed a short and narrow stricture at the level of L5 with proximal hydroureteronephrosis. Ureterolysis and ureteroplasty were successfully performed via the retroperitoneal route. The total operation time was 200 minutes, and the estimated blood loss was 10 mL. The patient was discharged on postoperative day 5 with no complications. At the 12-month follow-up, the patient reported complete relief from pain and intravenous pyelography showed markedly decreased hydroureteronephrosis.
Discussion: Retroperitoneoscopic laparoendoscopic single-site surgery is an effective treatment option for congenital midureteral stricture with an acceptable esthetic outcome and minimal morbidity.
Key Words: Ureteral obstruction, Midureteral stricture, Laparoendoscopic single-site surgery, Retroperitoneoscopy, Multicystic dysplastic kidney disease.