Primary Obstructive Megaureter in Children: to Treat or not?

Zampieri Nicola*, Cecchetto Mariangela, Patanè Simone, Vestri Elettra and Camoglio Francesco Saverio

Objective: Primary obstructive megaureter has always been considered a developmental defect. Surgical and conservative treatments were compared through a retrospective study first, and then in a longitudinal observational study. 

Materials and methods: Between January 1993 and January 2006 at our Department 42 cases of primitive obstructive megaureter were observed. Patients were divided into two groups: treated and untreated, each with inclusion and exclusion criteria. The efficacy of surgical treatment vs. conservative treatment was assessed through routine laboratory tests, ultrasound of the urinary tract and renal scintigraphy. Follow-up was at least 2 years for all patients. 

Results: 26 patients were eligible for the study. Of these, 12 patients underwent surgery and 14 patients received conservative treatment. At diagnosis the left kidney resulted the most compromised and no patient showed improved renal function at the end of the study. Single or relapsing infections of the urinary pathway did not seem absolute indications for surgical treatment. It was not possible to observe a correlation between obstruction grade, ureteral dilation and renal function at scintigraphy nor predictive factors specific for this clinical situation. 

Conclusions: The management of primitive obstructed megaureter in children is still a controversial issue. If in the past surgical treatment was considered, sooner or later, an essential procedure, it has been proved that it has no advantages with respect to the conservative treatment. Single or relapsing infections of the urinary pathway and relative renal function > of 40% do not need surgery.

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Published on: May 31, 2019 Pages: 1-4

Full Text PDF Full Text HTML DOI: 10.17352/aur.000004
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