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


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


ureter, primary magureter, obstructive uropathies, ureteral reimplantation


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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Wiesław Urbanowicz
Uniwersytecki Szpital Dziecięcy
Klinika Urologii Dziecięcej
30-663 Kraków
Wielicka 265
lei. (0-12)6572131