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Primary obstructive megaureter with giant ureteral stone: a case report
Abdullah Demirtaş1, Nurettin Sahin, Emre Can Akınsal
1Department of Urology, Erciyes University Medical Faculty, 38039 Kayseri, Turkey.
Case Reports in Urology
|March 28, 2013
Summary
A large pelvic stone caused severe left kidney swelling (hydronephrosis) and a blocked ureter (megaureter). Surgical intervention successfully removed the stone and reconstructed the ureter, restoring kidney function.
Area of Science:
- Urology
- Nephrology
- Radiology
Background:
- A 19-year-old male presented with a four-year history of intermittent flank pain.
- Imaging revealed a large radiopacity on the left pelvic bone (6x4 cm).
- Intravenous pyelography (IVP) demonstrated a significantly dilated left ureter (megaureter) with a lower-ureteral stone and grade V hydronephrosis.
Purpose of the Study:
- To report a case of a large pelvic ureteral stone causing severe hydronephrosis.
- To describe the surgical management and outcomes of this rare presentation.
Main Methods:
- Diagnostic imaging including X-ray and IVP.
- Surgical procedures: left ureterolithotomy, left nipple ureteroneocystostomy, and psoas hitch.
- Post-operative assessment with voiding cystourethrogram and IVP.
Main Results:
- Successful surgical removal of the ureteral stone.
- Post-operative imaging showed no vesicoureteral reflux.
- Reduced dilatation of the collecting system and improved kidney drainage compared to pre-operative IVP.
Conclusions:
- Surgical management involving ureterolithotomy, ureteroneocystostomy, and psoas hitch is effective for large ureteral stones causing severe hydronephrosis.
- The described surgical techniques can successfully restore renal function and prevent reflux.
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