Primary obstructive megaureter in a twelve-month old: A case report

Prenatal hydronephrosis is a common finding that resolves spontaneously in low-risk infants. Persistent hydroureteronephrosis requires careful evaluation. This case outlines a rare presentation of ectopic, nonduplicated ureter with distal strictures. A female infant with severe left-sided hydroureteronephrosis was found to have persistent upper tract dilation. Diagnostic cystoscopy with retrograde pyelogram revealed an ectopic, nonduplicated ureter with distal obstruction. Open reconstruction identified a tortuous megaureter with multiple distal strictures, managed with ureteral tapering and reimplantation. Anatomic variants should be considered in infants with persistent hydroureteronephrosis and refractory, recurrent infections. Early recognition and surgical intervention can result in an excellent clinical outcome.