Primary megaureter

Discussion:

Megaureter in an adult is often due to distal obstruction, occasionally gross reflux or commonly idiopathic (i.e. developmental). Even if idiopathic the patient can be symptomatic due to urinary stasis leading to recurrent infection or calculi. The key to diagnosing an idiopathic cause is the absence of obstruction on a frusemide nuclear renal scan, lack of reflux on MCUG and the absence of calyceal dilatation and renal parenchymal thinning as would be expected in a chronically obstructed kidney that could lead to such ureteric dilatation.

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