Chronic, gross hematuria caused by idiopathic ureteric stricture

Abstract

An otherwise healthy, 10-year-old boy presented with chronic, gross hematuria. This persisted daily for 5 years despite extensive multidisciplinary workup with renal biopsy and resulted in severe iron deficiency anemia. The extensive workup and requirement for routine follow-up, investigations, and procedures led to significant psychosocial distress for the patient. Initially, it was thought the patient had a nutcracker phenomenon, but on closer inspection of his ureters, an idiopathic, unilateral ureteric stricture was discovered and, after 8 weeks of stenting, resulted in complete resolution of the hematuria. Importantly, the patient's psychosocial distress resolved after resolution of the hematuria and with the closure that came with a diagnosis.