Giant Ureterohydronephrosis Due To A Ureteral Stone

A 61-year-old man presented with left renal colic pain within 5 days. He had no history of ureteral colic and no family history of renal stone disease. Physical examination revealed left costovertebral angle tenderness and a palpable mass in the left flank region. Roentgenelogic examination including direct urinary system graphy showed a left pelvic radiopaque nodule (Figure 1). The serum creatinine level was 1.8 mg/dl. The rest of the laboratory parameters were within normal limits. Computed tomography of the abdomen revealed a left lower ureteral stone (2.5cm) and giant ureterohydronephrosis (Figure 2 A, B, C). He received ureteroscopic lithotripsy and placement of a double-J ureteral stent. The most common cause of the giant hydronephrosis is ureteropelvic obstruction, stones, tumors and trauma. Urolithiasis could present asymptomatically and result in a rare condition termed giant hydronephrosis, defined as the presence of more than 1 L of fluid in the collecting system [1]. As in our case the reason of the hydronephrosis and hydroureter is the obstruction caused by a distal ureteral stone. Percutaneous nephrostomy followed by subsequent lithotripsy and even nephrectomy in the case of non-functioning kidney may be the other treatment options.