A Rare Case of Congenital Megaureter in Adult with Classical Presentation

Introduction: Congenital megaureter is a condition usually diagnosed in neonates and children; its primary presentation in adults is rare. Spontaneous resolution occurs in over half of all affected children, and this is hypothesized to occur as a result of the ureterovesical junction (UVJ) maturation and growth. When this condition does present in adults, it typically does so during the third or fourth decade, and unilateral disease, most often left-sided is more common than bilateral disease. Presentation of Case: A forty five year old female patient presented with recurrent attacks of left ureteric colic since 5 months. On examination, abdomen was soft and non-tender. Patient was referred for Contrast Enhanced Computed Tomography (CECT) KUB, which showed left sided megaureter and delayed excretion of contrast with maximum diameter of 4cm and left hydronephrosis. The patient then underwent Magnetic Resonance (MR) urography which confirmed the CECT KUB findings. Patient was then advised to undergo ureteroplasty. Conclusion: Primary presentation of congenital megaureter in adults is rare. It is expected that leaving the underlying abnormality intact may pose the patient to the stone formation and urinary tract infection causing persistence of symptoms.