Abstract

BackgroundPrimary obstructive megaureter is relatively uncommon in adults. This condition usually regresses spontaneously or is treated during infancy. It can remain asymptomatic for decades until adulthood when symptoms may manifest in the event of complications or during a routine radiologic imaging. Primary obstructive megaureter has been reported to favor stone formation in the upper urinary tract.Case presentationWe present the case of a 35-year-old Moroccan man who had a 10-year history of intermittent left flank pain and hematuria. A computed tomography urogram revealed a left megaureter with giant ureteral and renal calculi.ConclusionsPrimary obstructive megaureter should be a differential diagnosis in an adult with hydroureteronephrosis associated with urolithiasis especially when there is kidney impairment. Through this case report we will discuss the diagnosis and management of primary obstructive megaureter associated with urolithiasis in adults.

Highlights

  • Primary obstructive megaureter is relatively uncommon in adults

  • Primary obstructive megaureter should be a differential diagnosis in an adult with hydroureteronephrosis associated with urolithiasis especially when there is kidney impairment

  • Through this case report we will discuss the diagnosis and management of primary obstructive megaureter associated with urolithiasis in adults

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Summary

Conclusions

POM complicated by urolithiasis in an adult can be mistaken for ureterohydronephrosis secondary to urolithiasis as these conditions have similar clinical manifestations and radiological imaging cannot differentiate between them, especially when there is renal function impairment. Radiological imaging appears to be a very useful tool to differentiate between these conditions and to avoid any errors in diagnosis. IVP and CT urography are very important diagnostic tools to identify a POM. Voiding cystogram and cystoscopy are required to rule out bladder outlet obstruction and any secondary causes of obstructed ureter in order to confirm the diagnosis of POM. Urolithiasis associated with POM in adults requires surgery in order to avoid renal function impairment and other complications

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