Primary obstructive megaureter in adults: management strategy in a young woman

Primary obstructive megaureter is an uncommon disease in adults. We describe a case in a thirty years old woman affected by monolateral megaureter complicated by ureteric calculi.

The clinical presentation, renal function, radiologic data, complications and treatment were studied.

The patient, with a history of recurrent right flank pain in the last ten years, had a right primary obstructive megaureter radiologically revealed complicated by ureteric calculi. Omolateral kidney result malrotate. Extensive ureteral tailoring with an extravesical ureteral reimplantation was performed. The calculi were removed at the time of ureteroneocystostomy.

Adult and adolescent primary obstructive megaureter is a congenital abnormality that do not regress. Complications such us stone formation and altered function of the affected kidney are common and when associated to recurrent urinary tract infections require surgical intervention. Conservative management probably has a role only in the uncomplicated primary megaureter patients with normal creatinine clearance and who have possibility of a regular lifelong follow-up.