Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with chronic right-sided flank pain, recurrent urinary tract infections, or hematuria. History is significant for obstructive uropathy symptoms. Imaging (CT/MRI) confirms the ureter passes posterior to the inferior vena cava, resulting in proximal hydroureteronephrosis.
Clinical Examination Findings
Abdominal examination reveals mild right flank tenderness. Renal angle percussion may be positive on the right side. No palpable masses or organomegaly noted. Cardiovascular exam is unremarkable; blood pressure is stable.
Treatment Protocol
Surgical intervention indicated for symptomatic obstruction or progressive renal function decline. Procedure: Ureterolysis and ureteroureterostomy with transposition of the ureter anterior to the inferior vena cava. Post-operative management includes DJ stent placement and serial monitoring of renal function.