SYMPTOMATIC AND COMPLICATED PRIMARY OBSTRUCTIVE MEGAURETER IN 18 Y.O. CAUCASIAN MALE PATIENT: LAPAROSCOPIC APPROACH
An 18-year-old male patient with no previous history of surgery and no comorbidities, was diagnosed with severe right hydroureteronephrosis after the admission to our hospital for fever, right flank pain and leucocytosis. Renal dynamic scan showed a reduced functioning right kidney with a split function of 28%. Computed tomography scan demonstrated a marked dilation of the right pelvicaliceal system with reduced thickness of the renal parenchyma associated with a megaureter with radiological appearance of “Low Narrow Tapering Sign” suggestive of Primary Megaureter. The left kidney had a normal anatomy and function. The patient was admitted for laparoscopic ureteral reimplantation with intracorporeal tailoring of the medial and distal parts.
The operative time was 210 minutes. Blood loss was minimal. A tubular vacuum drain was left for 48 hours. The Foley catheter was removed on the third postoperative day and the patient was discharged from the hospital 5 days after surgery.
Follow-up ultrasonography and intravenous urography 1 month later confirmed good drainage combined with a significant reduction in hydroureteronephrosis.