Question

Symptoms of megaureter.

Hint:

Megaureter may present with symptoms such as flank pain, UTIs, and hematuria, with more severe symptoms seen in cases of obstruction.

Answer 1

The symptoms of megaureter depend on the underlying cause, whether it is obstructive or non-obstructive, and the severity of the condition. Some patients may remain asymptomatic, especially in cases of non-obstructive megaureter, while others may present with more severe symptoms.
Step 1: Common Symptoms:
1. Flank Pain: Dilation of the ureter and the accumulation of urine can lead to discomfort or pain in the flank or lower abdomen. This is more common in obstructive megaureter.
2. Urinary Tract Infections (UTIs): Patients with megaureter may be more prone to urinary tract infections due to urine stasis, which provides a medium for bacterial growth. Symptoms of UTIs include fever, dysuria, and increased frequency of urination.
3. Hematuria: Blood in the urine may occur due to the stretching of the ureter or secondary infection.
4. Hydronephrosis Symptoms: In cases of obstructive megaureter, the patient may experience symptoms related to kidney swelling (hydronephrosis), such as back pain, nausea, and vomiting.
5. Palpable Mass: In severe cases, a dilated ureter may be palpable as a mass in the abdomen or flank area.
Step 2: Symptoms Specific to Obstructive Megaureter:
1. Progressive Pain and Swelling: As urine accumulates due to the obstruction, there is a risk of further renal damage and increasing pain in the affected area.
2. Decreased Urinary Output: In some cases, obstructive megaureter can reduce urinary output or cause intermittent urinary retention.
Step 3: Symptoms in Neonates and Infants:
In newborns, megaureter may present with symptoms such as failure to thrive, vomiting, and poor feeding, particularly if the condition leads to a urinary tract infection or significant renal dysfunction.