Abstract
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.