The nutcracker syndrome: an uncommon cause of haematuria

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Abstract
Objective To increase the awareness of this rare cause of haematuria and to describe the operative techniques available for its treatment. Patients and methods The investigation and treatment of five patients with the nutcracker syndrome have been reviewed. Results A new variant of the nutcracker syndrome is described. Using a combination of venolysis, Gortex graft renal vein interposition and an anterior nephropexy, the haematuria of four patients has ceased and improved in one. Conclusion The nutcracker syndrome is a rare cause of haematuria which responds successfully to surgical treatment. Successful treatment does not appear to be related to lowering of the renal vein pressure.