Missing Ureter: Insights from a Urology Case Study

The ureter below the kidney is absent..?

I visited the doctor last October due to hematuria, and the physician prescribed some medication.
Urinalysis and blood tests only showed an elevated red blood cell count without any abnormalities or stones.
Later, I went to a small clinic for evaluation of kidney issues and lower limb edema.
The doctor performed an ultrasound and suggested the possibility of small stones, recommending increased water intake and prescribing diuretics to reduce swelling.

This year, for insurance purposes, I underwent further ultrasound and intravenous pyelogram (IVP) examinations.
The urologist confirmed that my right ureter is missing for nearly two centimeters due to unknown external or internal factors.
Yes, it is truly absent; the missing section is located below the kidney, while the lower segment is visible.
Currently, I only experience occasional pain in the lower right abdomen, with no other symptoms.
The doctor mentioned that I need to undergo retrograde pyelography for further evaluation.
Based on my medical history, can you provide any insights? I am hesitant to undergo continuous further examinations, and I wonder if waiting for symptoms to arise before seeking medical attention would delay diagnosis and treatment.
I would greatly appreciate your response.
Thank you.
Note: Female, 27 years old, unmarried, with a good health record since last year.

tt, 20~29 year old female. Ask Date: 2002/03/13

Dr. Du Shixi reply Urology

Hello, your ureter is not missing; it may not have been captured in the imaging.
The contrast agent flows within the ureter, and if the volume is low, it may not be visible.
However, since you have hematuria, please be attentive to follow-up appointments for continued monitoring.
There are indeed cases of persistent hematuria where a detailed examination fails to identify the cause.
I recommend that you regularly visit a hospital for follow-up (every six months or three months) for safety.

Reply Date: 2002/03/13

More Info

Understanding the complexities of urological conditions, particularly those involving the urinary tract, can be quite challenging. In your case, the discovery of a missing segment of the right ureter, as indicated by your recent imaging studies, raises several important considerations.

Firstly, the ureter is a crucial component of the urinary system, responsible for transporting urine from the kidneys to the bladder. The absence of a segment of the ureter can be due to a variety of factors, including congenital anomalies, previous surgical interventions, or even trauma. In your situation, the fact that the missing segment is located near the lower kidney and that you have experienced occasional right lower abdominal pain suggests that there may be an underlying issue that requires further investigation.

The initial findings of hematuria (blood in urine) and the presence of red blood cells in your urine could indicate a variety of conditions, ranging from urinary tract infections (UTIs) to kidney stones or even more serious conditions such as tumors. While your subsequent tests did not reveal any stones or significant abnormalities, the presence of a missing ureter segment is concerning and warrants further evaluation.

The recommendation for a retrograde pyelogram (RGP) is a standard procedure in urology that allows for a more detailed assessment of the urinary tract. This test involves the insertion of a contrast dye into the ureter to visualize its structure and function. It can help determine the cause of the missing segment and assess whether there are any obstructions or abnormalities that need to be addressed.

Regarding your concerns about undergoing additional tests, it is understandable to feel apprehensive about repeated procedures. However, it is essential to weigh the risks of not investigating further against the potential benefits of identifying any underlying issues. If the missing ureter segment is causing intermittent pain or could lead to complications such as hydronephrosis (swelling of the kidney due to urine buildup), timely intervention may be necessary.

In terms of your current health status, being 27 years old and generally healthy is a positive factor. However, the absence of a ureter segment can lead to complications, such as urinary stasis or recurrent infections, which could affect your overall health. It is crucial to maintain open communication with your urologist, discussing your concerns and preferences regarding further testing and management options.

In summary, while it may be tempting to delay further investigations until symptoms worsen, proactive management is often the best approach in urology. The missing ureter segment could have implications for your urinary health, and understanding the underlying cause is vital for preventing potential complications. It is advisable to follow through with the recommended retrograde pyelogram and any subsequent evaluations to ensure that you receive appropriate care tailored to your specific condition. Your health and well-being are paramount, and addressing these concerns now could lead to better outcomes in the future.

Similar Q&A

Understanding Ureteral Issues: Options After Surgical Complications

Dear Doctor: If the ureter was severed during surgery and then reconnected, but the reconnected ureter did not survive, I would like to ask if the only treatment option is ureteral reconstruction? Thank you.

Dr. Sun Hongshun reply Urology
Hello, I am not sure what a non-functional ureter is. If you have this issue, it is essential to visit a large medical center for an evaluation by a urologist to determine the appropriate surgical intervention. Wishing you good health.

Understanding Ureteral Reconstruction and Kidney Function Assessment

Hello, Dr. Hsu. I previously consulted you about the issue of "ureteral reimplantation," and I saw your response. Thank you! After being discharged, my follow-up appointment included an ultrasound, which revealed hydronephrosis in the left kidney (after the left urete...

Dr. Xu Weikai reply Urology
Hello, I'm not sure either. It might be the ratio of urine excretion from the two kidneys: one side at 42.7% and the other at 57.3% (just a guess). To determine if there is any swelling in the ureters, an ultrasound or an intravenous pyelogram (IVP) can be used. If there are...

Understanding Complications After Ureteral Reconstruction Surgery

During a health check-up two years ago, ureteral stenosis was discovered. In early November of last year, I underwent Da Vinci surgery (ureteral reconstruction), and the double J stent was removed on December 16. During an ultrasound on January 19, I was informed that there was m...

Dr. Cai Zhuorong reply Urology
If the ureter has been narrowed for a period of time, the renal pelvis may lose its elasticity and appear hydronephrotic. In fact, as long as there is no further obstruction after ureteral surgery, it is considered a success.

Can Pre-Surgery Tests Reveal Ureter Shape for Kidney Stone Removal?

Hello Doctor: My friend previously underwent a ureteroscopy to remove a stone lodged in the ureter, but after the procedure, the doctor said the ureter was too curved to insert the instrument, so the stone could not be removed. However, X-rays were taken beforehand; why was it no...

Dr. Du Shixi reply Urology
Hello: Imaging examinations are not always 100% accurate; some curved or narrowed areas may not be passable with an endoscope. However, there are flexible ureteroscopes that can overcome some of these situations. Unfortunately, this procedure is not covered by health insurance, s...