Introduction: Giant hydronephrosis, which implies a collecting system containing more than one liter of fluid, is becoming increasingly rare with the widespread availability of imaging facilities. We aimed to report a case and management of bilateral giant hydronephrosis due to bilateral ureteropelvis stenosis.
Case presentation: A 45-year old male presented at the Emergency Department with the complaint of difficulty passing stools. On computed tomography (CT), bilateral giant hydronephrosis was determined covering the whole abdomen. After bilateral nephrostomy, 8 liters of urine was drained from the right kidney and 10 liters of urine from the left kidney after bilateral nephrostomy in the patient whose serum creatinine level was 1.06 mg/dl at the time of admission. Bilateral pyeloplasty was applied to the patient who was diagnosed with bilateral ureteropelvis stenosis after dynamic renal scintigraphy. After 4 years of follow-up, serum creatinine level was 1.3 mg / dl. Hydronephrosis was still present despite being smaller than its previous condition and the presence of bilateral double J stents.
Conclusions: An interesting finding of the current case was that the creatinine level might be normal despite the fact that bilateral giant hydronephrosis. So rather than nephrectomy, pyeloplasty was applied and to date there has been no need for hemodialysis.