Congenital Midureteric Stricture: Challenges in Diagnosis and Management

Table 1

Salient clinical features and findings on different diagnostic tools in patients with midureteric stricture.

Case number	Presentation	Age/sex	Ultrasonography	IVU	Differential function of affected side	MRU	Retrograde pyelography	Operation
1	UTI	5 months/female	Antenatal USG-right side, grade 2 HDN	Dilated PCS with impaired drainage—PUJ	34%	—	—	Ureter-ureteric anastomosis over D-J stent
2	UTI	8 months/male	Left side, grade 3 HDN with upper ureteric dilatation	Delayed drainage from PCS with dilated upper ureter	35%	Abrupt ureteral narrowing at obstructed area—dilated PCS and proximal ureter	Confirmed on RGP	Ureter-ureteric anastomosis over D-J stent
3	Antenatal hydronephrosis on right side	4 months/male	Right side, grade 2 HDN	Dilated PCS with impaired drainage—PUJ	35%	Delineates the site of obstruction; Proximal dilatation of ureter and PCS	Confirmed on RGP	Ureter-ureteric anastomosis over D-J stent
4	—	6 months/male	Crossed left to right ectopia, grade 2 HDN	Two renal units on right side, with HDN in one unit	27%	Crossed left to right ectopia with—dilated ureter and pelvis of left renal unit	—	Ureteric reimplantation
5	Antenatal hydronephrosis	5 months/male	Left side, grade 2 HDN with ureteric dilatation	Grade 3 hydroureteronephrosis	28%	MRU revealed midureteric obstruction	Confirmed on RGP-	Ureter-ureteric anastomosis over D-J stent