Primary Obstructive Megaureter

muammerakyol's picture
Author(s)
Muammer Akyol , Alperen Kayal, Fitnet Sonmezgoz
MD
Firat University; Elazig, TR
Images

Figure Legends : 

 35 years old male patient admitted with recurrent genitourinary tract infection and left flank pain

Case Description

Clinical History: 

 Primary obstructive megaureter (POM) is dilatation of ureter due to a functional obstruction at distal ureter. It could be seen all ages. It is the second cause of intrauterin hydronephrosis. It is seen uncommonly in adults. The male to female ratio is 4/1. It is usually unilateral (it is seen at left ureter more than 3-4 times to right ureter) and it is bilateral %15-25 of cases. Although it is known as a nonhereditary anomaly, some familial cases have also been reported. Most of the cases are asymptomatic and detected incidentally. The most common symptom is urinary infection in childhood and flank pain in adults. Most of the patients heal spontaneously.

Diagnosis: 

 IVU (intravenous urography) shows about 3 cm narrow segment left distal ureter and dilatation of proximal segment. On the flouroscopic examination there was no peristaltism. Sagittal sonogram shows dilated distal ureter and narrow segment (arrow).

Discussion: 

 Primary obstructive megaureter

References / Suggested Reading: 

  1. Sheah KBJ, Yip SKH, Joseph VT. Clinics in diagnostic imaging of primary obstructive megaureter. Singapore Med J 2001; 42: 233-237.
  2. Hamilton S, Fitzpatrick JM. Primary non-obstructive megaureter in adults. Clin Radiol 1987; 38: 181-185.
  3. Perlmutter AD, Retik AB, Bauer SB. Anomalies of the upper urinary tract. In Walsh PC, Gittes RF, Perlmutter AD, Stamey TA, eds. Campbell's Urology. 5th ed. Philadelphia: WB Saunders, 1986: 1726-1730.
  4. Shokeir AA, N?jman RJM. Primary Megaureter: current trends in diagnosis and treatment. BJU International 2000; 86: 861-868.
  5. Dahnert W. Radiology Review Manual. 3rd ed. Baltimore: Williams & Wilkins, 1996. Merlini E, Spina P. Primary non-refluxing megaureters. Journal of Pediatric Urology 2005; 1: 409-417.
  6. Tatu W, Brennan RE. Primary megaureter in a mother and daughter. Urol Radiol 1981; 3: 185-187.
  7. Yavascaoglu I, Alper E, Akcaglar S, et al. Primary megaureter in a mother and daughter. BJU 1998; 82: 923-924.
  8. Kiris A, Kocakoc E, Boztosun Y, Sen Y. Case report: primary obstructive megaureter: intravenous urography and ultrasonographic findings. Turk Diagn Interventional Radiology 2002; 8: 448-450

Citation:

Primary Obstructive Megaureter, Muammer Akyol , Alperen Kayal, Fitnet Sonmezgoz, Imaging Science Today, 2009, 95.

Comments

muammerakyol's picture
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Joined: 03/25/2008

We have sent this article two times by mistake.

 

 

vdogra's picture
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Joined: 12/09/2007

Muammerakyol:

Duplicate case has been removed. Please feel free to submitt additional cases. I appreciate your support.

Vikram S Dogra,MD
Professor of radiology,Urology &BME
University of Rocheter, NY, USA

Vikram Dogra, MD Professor of Radiology,Urology & BME University of Rochester, NY