10/03/2026
Rare Case of Retrocaval Ureter Successfully Managed at Urology Unit-I, Mayo Hospital Lahore
A 15-year-old male presented with complaints of right flank pain. Initial ultrasound revealed right-sided hydronephrosis with proximal hydroureter. Further evaluation with CT Urography (CTU) showed gross dilatation of the proximal ureter with suspicion of a mid-ureteric stricture.
To further delineate the pathology, Retrograde Pyelography under fluoroscopy was performed. Interestingly, it demonstrated the classic “Fish-Hook sign,” leading to the diagnosis of a rare congenital anomaly — Retrocaval (Circumcaval) Ureter, in which the ureter passes posterior to the inferior vena cava, causing obstruction.
The patient underwent surgical correction with ureteral dissection and end-to-end ureteroureterostomy, performed successfully by Dr. Muhammad Waqas, Assistant Professor Urology-I under supervision of Prof. Dr. Fawad Nasrullah.
The patient has an excellent postoperative recovery and is doing well in ward.
This case highlights the importance of careful radiological evaluation and intraoperative decision-making in rare urological anomalies.
Urology Unit-I, Mayo Hospital Lahore remains committed to delivering advanced and compassionate urological care.