• Leonardo Lima Borges, Fábio César Miranda Torricelli, Gustavo Xavier Ebaid, Antônio Marmo Lucon, and Miguel Srougi.
• Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
• Sao Paulo Med J. 2010 May 1; 128 (3): 174176174-6.

ContextUreteral stenosis and ureterohydronephrosis may be serious complications of aortoiliac or aortofemoral reconstructive surgery.Case ReportA 62-year-old female patient presented with a six-month history of left lumbar pain. She was a smoker, and had mild chronic arterial hypertension and Takayasu arteritis. She had previously undergone three vascular interventions. In two procedures, Dacron prostheses were necessary. Excretory urography showed moderate left ureterohydronephrosis and revealed a filling defect in the ureter close to where the iliac vessels cross. This finding was compatible with ureteral stenosis, and the aortoiliac graft may have been the reason for this inflammatory process. The patient underwent laparotomy, which showed that there was a relationship between the ureteral stenosis and the vascular prosthesis. Segmental ureterectomy and end-to-end ureteroplasty with the ureter crossing over the prosthesis anteriorly were performed. There were no complications. The early and late postoperative periods were uneventful. The patient evolved well and the results from a new excretory urogram were normal. We concluded that symptomatic ureterohydronephrosis following aortoiliac graft is a real complication and needs to be quickly diagnosed and treated by urologists.

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