Results of the surgical treatment of primary obstructive megaureters
Article published in Urologia Polska 2002/55/2.

authors

Wiesław Urbanowicz, Marek Górniak: Klinika Urologii Dziecięcej Uniwersyteckiego Szpitala Dziecięcego w Krakowie Kierownik kliniki: dr hab. Wiesław Urbanowicz

keywords

ureter, primary magureter, obstructive uropathies, ureteral reimplantation

summary

Purpose. We reviewed and analysed the results of our surgical treatment of primary obstructive megaureters in neonates, infants

and older children. Method. From 1995 to 2001, 67 children were treated for primary obstructive megaureter. In 63 of them surgical treatment was

necessary and they underwent partial resection of the lower part of the ureter and ureteroneocystostomy m. Poltiano-Leadbe-

tter or m. Mathisen. In 12 patients narrowing of the reimplanted ureter was done, using the method of Hendren, Kalicinski or

Starr. Five patients underwent transient percutaneous nephrestomy before the operation. Results. Postoperatuve renal scintigraphy and intravenous pyelography revealed improvement of the renal function in all patients.

In 10,4% of them the vesicoureteral reflux was observed and they were treated by endoscopic ostial injection. None of patients

had stricture recurence after surgery. Conclusions. Patients with primary obstructive megaureters should be observed before treatment. The surgical method of choice

is a resection of the stricture and anti-refluxing reimplantation of the ureter. In patients with considerably enlarged ureters,

surgical narrowing schould be performed.

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correspondence