Urolithiasis in primary obstructive megaureter: a management dilemma.

Area of Science:

• Urology
• Nephrolithiasis Management
• Minimally Invasive Surgery

Background:

• Megaureter with urolithiasis is rare and challenging due to stone mobility and multiplicity.
• Current management lacks standardized guidelines, relying on surgeon experience and stone characteristics.
• The objective is to achieve stone clearance and ureteral reimplantation in a single operative session.

Observation:

• A patient presented with bilateral multiple ureteral and left renal stones.
• Left ureteral stones were flushed into the kidney and removed via percutaneous nephrolithotomy.
• Right lower ureteral stones were managed with simultaneous ureteroneocystostomy.

Findings:

• Successful single-stage management of bilateral megaureter with urolithiasis was achieved.
• The described technique involved a combination of ureteroscopy, percutaneous nephrolithotomy, and ureteroneocystostomy.
• Complete stone removal and successful ureteral reimplantation were accomplished in one session.

Implications:

• This case demonstrates a feasible and effective single-stage surgical strategy for complex megaureter urolithiasis.
• The findings may inform the development of standardized treatment protocols for this uncommon condition.
• This approach offers a potentially less invasive and more efficient treatment option for patients with bilateral ureteral and renal stones.