Objective: Megaureter is an uncommon presentation in the adult patients, we describe a case of a ninety years old woman asymptomatic for long part of her life, affected by bilateral MGU.
Material and method: The clinical presentation, renal function, radiologic data, complications and treatment were studied.
Result: The patient had a bilateral MGU radiologically revealed, asymptomatic for a long time. Just in the last two months she had bilateral loin pain and urinary infections, without other complications. We decided to act a watchful waiting strategy without any surgical interventation but proceeding with antibiotic suppression and close radiologic surveillance.
Conclusion: Most adults patients with MGU are asymptomatic. Complications such as stone formation and altered function of the affected kidney are common and when associated to recurrent UTI require surgical interventation. Functional reserves of the kidney, transportation capacity of the upper urinary tract, histological changes of the ureter are other important criteria for surgery option of treatment. When renal failure is advanced interventation is not necessary. Otherwise if the patient is completely asymptomatic, conservative treatment may be employed effectively in adults in whom conditions are often stable and complications are absent.