From bladder distension to ureteral dissection: A radiologic revelation

Wijdane Talbi; Rabab Hassani; Youssef Sakhy; Houria Tabakh; Abdellatif Siwane; Najwa Touil; Omar Kacimi

doi:10.5455/ajdi.20251018063814

Abstract
Introduction: Ureteral dissection is an extremely rare urological condition, best diagnosed through computed tomography (CT).
Case Report: A 54-years-old man with no significant history presented with longstanding dysuria and sudden-onset left flank pain. Ultrasound revealed bilateral ureterohydronephrosis with a distended bladder. CT scan showed spontaneous left ureteral dissection secondary to bladder distension from benign prostatic hypertrophy. Conservative management with bladder drainage led to complete recovery.
Discussion: Ureteral dissection represents a transient stage before rupture. Diagnosis relies on CT imaging showing the “double-lumen sign.” Recognition of this finding enables early management to prevent rupture, urinoma, or infection.
Conclusion: Spontaneous ureteral dissection is rare but should be considered in atypical flank pain with urinary obstruction. Early CT evaluation ensures accurate diagnosis and favorable outcomes.

Key words: ureteral dissection, bladder distension, benign prostatic hypertrophy, computed tomography.