# Case Report: A rare case of renal failure secondary to in utero megalourethra

## TL;DR

A rare case of a male infant with megalourethra leading to sudden kidney failure and low amniotic fluid is reported, highlighting the need for early diagnosis and intervention.

## Contribution

This case presents a novel instance of rapid-onset anhydramnios and renal failure in a fetus with megalourethra.

## Key findings

- The patient developed anhydramnios and renal failure at 34 weeks despite normal amniotic fluid levels earlier.
- Proximal urethrostomy may be a potential intervention to bypass megalourethra and prevent infection.
- Long-term dialysis and multiple surgeries are expected for the patient's management.

## Abstract

Megalourethra is a rare congenital condition marked by dilation and elongation of the penile urethra, resulting from hypoplasia of either the corpus spongiosum or corpus cavernosa.

We describe a novel case of a male infant prenatally diagnosed with megalourethra who subsequently developed rapid-onset anhydramnios and advanced renal failure.

Unlike previously described cases, this case is unique due to the patient's abrupt progression to anhydramnios at 34 weeks and 5 days, despite having normal amniotic fluid levels prior to that. With late-onset anhydramnios, the severity of renal dysfunction was unexpected. Proximal urethrostomy requires further assessment as a potential intervention to successfully bypass the megalourethra and prevent infection. Long-term management is expected to include dialysis as a bridge to transplantation. Multiple corrective urological surgeries will be required to repair the urethra and restore penile function. Timely prenatal diagnosis of megalourethra or renal anomalies is essential for predicting long-term prognosis, as these conditions can lead to significant postnatal complications.