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A 16-year-old male presented with asymptomatic left hydronephrosis on routine examination, with inflammatory findings on laboratory tests. Ultrasound, CT urography, ureteroscopy, and retrograde pyelography localized severe hydronephrosis and a stricture at the fifth lumbar vertebra level. Laparoscopic segmental resection with stenting and anti-inflammatory therapy achieved complete radiologic resolution at 3 months.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/adolescent-idiopathic-ureteral-stricture-a-multimodal-diagnostic-and-surgical-approach-in-resolving-hydronephrosis/455065/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/adolescent-idiopathic-ureteral-stricture-a-multimodal-diagnostic-and-surgical-approach-in-resolving-hydronephrosis/455065.png","ImageObject",300,407,{"name":92,"@type":93},"Mary Man","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-31","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":52},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Why are adolescent idiopathic ureteral strictures difficult to manage?","Question",{"text":112,"@type":113},"They are exceptionally rare and their etiology is unclear, leaving gaps in understanding and limited pediatric-specific management guidance.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How was the stricture location determined in the case?",{"text":117,"@type":113},"Urinary tract ultrasound and CT urography showed severe hydronephrosis and ureteral wall thickening, while ureteroscopy and retrograde pyelography localized the stricture at the fifth lumbar vertebra level.",{"name":119,"@type":110,"acceptedAnswer":120},"What intervention was used, and what was the outcome?",{"text":121,"@type":113},"The patient underwent laparoscopic segmental ureteral resection with primary anastomosis, with concurrent laparoscopic ureteral stent placement and postoperative anti-inflammatory therapy; follow-up CT urography at 3 months showed complete resolution and successful stent removal.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},455065,1790816435,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":52,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":24,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144,"preview_page_count":4},7421720224475,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","®  \n Clinical Case Report   \nAdolescent idiopathic ureteral stricture A multimodal diagnostic and surgical approach in resolving hydronephrosis  \nZhongwei Liu, BMa , Denghui Huang, MMEDb , Wenjiang Yang, MMc ,*  \n\n| Abstract\u003Cbr>Rationale: Idiopathic ureteral strictures in adolescents are rare and poorly understood, posing diagnostic and therapeutic challenges due to their unclear etiology and lack of pediatric-specific management guidelines. Existing evidence predominantly derives from adult studies, leaving gaps in understanding pathophysiology, optimal interventions, and long-term outcomes in younger populations.\u003Cbr>Patient concerns: A 16-year-old male presented with asymptomatic left hydronephrosis detected during routine physical examination. Laboratory tests revealed elevated white blood cell count (12 × 10⁹/L) and 1+ leukocytes in urinalysis, prompting further investigation.\u003Cbr>Diagnoses: Imaging modalities, including urinary tract ultrasound and computed tomography urography, identified severe left hydronephrosis and pelvic ureteral wall thickening. Ureteroscopy and retrograde pyelography localized a stricture at the fifth lumbar vertebra level. Histopathological analysis confirmed chronic inflammation, vascular hyperplasia, and polypoid proliferation at the stricture site.\u003Cbr>Interventions: The patient underwent laparoscopic segmental ureteral resection with primary anastomosis, concomitant laparoscopic ureteral stent placement, and postoperative anti-inflammatory therapy.\u003Cbr>Outcomes: Follow-up computed tomography urography at 3 months demonstrated complete resolution of hydronephrosis and successful stent removal. The patient remained asymptomatic with normalized laboratory parameters.\u003Cbr>Lessons: This case highlights chronic inflammation as a potential driver of idiopathic ureteral strictures in adolescents, contrasting with fibrosis-dominated adult cases. It validates multimodal imaging and surgical resection as effective diagnostic and therapeutic strategies while emphasizing anatomical vulnerability at the fifth lumbar vertebra. The findings advocate for pediatric-focused research to explore inflammatory biomarkers, genetic predispositions, and minimally invasive alternatives.\u003Cbr>Abbreviation: CTU = computed tomography urography. |\n| --- |\n| Keywords: adolescent idiopathic ureteral stricture, chronic inflammation, hydronephrosis, multimodal imaging, ureteral resection and anastomosis |\n\n1. Introduction  \nUreteral strictures represent a significant clinical challenge in urology, with a complex etiology that spans congenital, inflammatory, traumatic, and iatrogenic origins. [1,2] While most cases  \nin the pediatric population are associated with congenital abnormalities or prior surgical interventions, idiopathic ureteral strictures remain exceptionally rare, particularly among adolescents.[3] This scarcity contributes to limited understanding of their pathophysiology and optimal management strategies,  \nThe written informed consent was obtained from all subjects and their legal guardians. The consent was for publication of all patients’of potentially identifying personal and medical information including any associated images.  \nThe authors have no funding and conflicts of interest to disclose.  \nData sharing not applicable to this article as no datasets were generated or analyzed during the current study.  \nThe study was conducted in accordance with the local legislation and institutional requirements. The participants provided their written informed consent to participate in this study. Written informed consent was obtained from the individual(s) for the publication of any potentially identifiable images or data included in this article.  \nWe confirm that informed consent was obtained from all subjects and their legal guardians. This study was approved by the Ethics Committee of the Wenshang County People’s Hospital, with the ethical approval number (2024004). We confirm that all experiments were performed in ac","cbCaiv673hbjczF9","https://ap.wps.com/l/cbCaiv673hbjczF9","pdf",692534,"English","# Abstract\n## Rationale\n## Patient concerns\n## Diagnoses\n## Interventions\n## Outcomes\n## Lessons\n# Introduction","[{\"question\":\"Why are adolescent idiopathic ureteral strictures difficult to manage?\",\"answer\":\"They are exceptionally rare and their etiology is unclear, leaving gaps in understanding and limited pediatric-specific management guidance.\"},{\"question\":\"How was the stricture location determined in the case?\",\"answer\":\"Urinary tract ultrasound and CT urography showed severe hydronephrosis and ureteral wall thickening, while ureteroscopy and retrograde pyelography localized the stricture at the fifth lumbar vertebra level.\"},{\"question\":\"What intervention was used, and what was the outcome?\",\"answer\":\"The patient underwent laparoscopic segmental ureteral resection with primary anastomosis, with concurrent laparoscopic ureteral stent placement and postoperative anti-inflammatory therapy; follow-up CT urography at 3 months showed complete resolution and successful stent removal.\"}]","Adolescent idiopathic ureteral stricture - A multimodal diagnostic and surgical approach in resolving hydronephrosis | PDF",1790742043,13]