Tran Henry, Kavanagh Alex, Steinbok Paul, Afshar Kourosh F
Department of Urological Sciences, University of British Columbia, Vancouver, BC;
Can Urol Assoc J. 2013 Jan-Feb;7(1-2):E115-7. doi: 10.5489/cuaj.251.
Large pelvic cysts and moderate to severe hydroureteronephrosis were found after investigating hypertension in a 16-year-old child with Marfan's and known pelvic dural ectasia. Follow-up magnetic resonance imaging demonstrated extensive ectasia of the dural sac at the sacral level with displacement of the bowel, bladder and bilateral ureteric obstruction with accompanying hydroureteronephrosis that was advanced compared to prior imaging. Postural headaches secondary to cerebrospinal fluid leak and progressive hydroureteronephrosis prompted a combined neurosurgical and urologic resection of the pelvic masses. In this report, we discuss the preoperative evaluation and management of this rare form of bilateral ureteric obstruction.