Urolithiasis in primary obstructive megaureter: a management dilemma.

Megaureter with urolithiasis is an uncommon entity. These stones may be located in the kidney, ureter or both. Management of these cases is difficult due to free mobility and stone multiplicity. As there are no guidelines about the management, the surgeon usually manages according to her/his experience, stone location or burden. The goal is to remove the stones and reimplant the ureters in the same session, if possible. We describe single-stage management of one such patient who presented with bilateral multiple ureteral and left renal stones. The left ureteral stones were first flushed into the kidney by the ureteroscope. Percutaneous nephrolithotomy was then performed and stones were removed intact. The patient was then turned supine and the location of right ureteral stones was confirmed by fluoroscopy in the same location (right lower ureter). The patient underwent successful bilateral ureteroneocystostomy with simultaneous removal of right lower ureteral stones. 2014 BMJ Publishing Group Ltd.