Urolithiasis in adults with congenital megaureter

Abstract

The primary presentation of congenital megaureter in adults israre. Development of urolithiasis may lead to this unusual underlyingdiagnosis. Urinary tract stones can form either within thedilated ureteral segment or in a part of the upper urinary tractproximal to the abnormal ureteral segment. We report two casesof nephrolithiasis that occurred in adults found to have segmentalmegaureter. The first case is that of a 58-year-old man whopresented with left lower quadrant pain. Computed tomographyscan revealed a 2-cm stone in the distal left ureter within an areaof isolated segmental distal ureteral dilation. The second case isa 48-year-old man who developed recurrent renal urolithiasisassociated with isolated distal megaureter.Although a rare condition in adults, congenital megauretermay present when kidney stones develop as a result of the ureteralabnormality. Typically, stones will develop within the dilatedsegment of ureter. Atypically, stones may develop away from thesite of the underlying abnormality. Congenital megaureter is adiagnosis that urologists and radiologists need to consider in thesetting of isolated distal ureteral dilation, as the diagnosis of adultmegaureter may require more involved surgical measures to preventrecurrence of adverse symptoms.