Uretero-vesical anastomotic stricture: a case report and review of management

Uretero-vesical anastomosis is the connection of the ureter to the urinary bladder at a new site to achieve unimpeded flow of urine from the ureters into the urinary bladder. A rare complication of this procedure is the development of stricture at the anastomotic site. This report is on a 62-yr. old female with one year history of left flank pain and a prior left uretero-vesical anastomosis done 14 years earlier. She had been managed for recurrent urinary tract infections, but the left flank pain was persistent. Abdominal and pelvic CT scan with intravenous urogram helped establish the diagnosis of uretero-vesical anastomotic stricture. This was successfully managed with endoscopic dilatation after retrograde placement of guide wire under fluoroscopy followed by serial dilation. In a patient presenting with flank pains after a previous uretero-vesical anastomosis, stricture at the anastomotic site is an important differential diagnosis. Endoscopic management is the preferred initial management which produces successful outcomes