Ces Urol 2000, 4(1):18-22 | DOI: 10.48095/cccu2000004

Operative treatment of primary obstructive megaureter

Z. Kurcinová¹, L. Valanský¹, V. Nagy¹, Ľ. Podracká²

¹ Urologická klinika FNsP, Košice

² Detská klinika FNsP, Košice

Primary obstructive megaureter (POM) was surgically tretated in a group 69 children at the age of 2,5 months - 4 years (mean 10,5 m.). At the time of diagnosis, from 82 ureterorenal units 52 (63%) showed damage to renal function, 3 5 (51%) children suffered from coexistent symptomatic urinary infection. In 32 children temporary percutanneous nephrostomy (2 bilat.) was performed because of pyelonephritis, extreme dilatation and/or renal damage. In 19 (56%) it has led to significant decrease of the grade of dilatation enabling to reimplant the ureter without the need of tapering. With 65 ureters Paquin method of reimplantation was used, 17 ones were tapered according to Hendren. Surgery normalised urine passage in 94% and has led to recovery, improvement and/or stabilization of renal function in 88%. Postoperative complications occured in 4 (6%) children - pyelonephritis exacerbation in 2, in another 2 ureterocystoneostomy stricture requiring surgical repair (successful). In 4 (6%) children with high grade POM serious preoperative kidney damage progressed despite the lack of obstruction after surgery and later on led to nephrectomy. The analysis of this group has confirmed that POM is a serious disease. Its early surgical treatment brings good and persistent results.

Keywords: Primary obstructive megaureter, Percutanneous nephrostomy, Surgical treatment

Published: January 1, 2000