Primary obstructed megaureter (POM) in children

Abstract

Abstract:The aim of this study was to analyze the results of surgical and conservative treatment of non-refl uxing POM. In the period 2000-2009, 45 children (52 ureters) were treated, the average age was 5.8 months (±10.33), 24 children (26 ureters) by surgery (I) and 21 children (26 ureters) by conservative means (II). The average follow-up period was 73.8 (±32.91) and 30.85 months (±23.1) resp. Urine examination, USG, DTPA 99mTc , biochemical testing, micturating cystouretography in all patients were performed. Signifi cant difference was present in the occurrence of hydronephrosis of 0th, 3rd and 4th grade, p<0.01, or p=0.17; next in the occurrence of normal ureter, 0-5 mm and dilated ureter >10 mm, p<0.01; and in the occurrence of normal and prolonged time T ½, p<0.01. The health condition was adjusted in 13 (54.20 %), improved on DTPA 99mTc in 5 (20.85 %), non-improved in 3 (12.50 %), deteriorated in 1 (4.15 %) and unknown in 2 (8.3 %) patients. In the IInd group a signifi cant difference was in case of occurrence of hydronephrosis of 0th, 2nd and 3rd grade, (p<0.01, or p=0.037 and p=0.011) and in occurrence of normal ureter, with ureter 0-5 mm and dilated ureter 5-10 mm, p<0.01. The condition at the end of the follow-up period was assessed DTPA 99mTc as adjusted in 11 (52.39 %) patients, improved in 6 (28.57 %), unimproved in 3 (14.28 %) and no patient was assessed as having deteriorated and unknown in 1 (4.76 %). Conclusion:In patients with an impaired separate kidney function, early surgical treatment helps to minimize damage to the kidney function and prevents future complications (Tab. 6, Fig. 3, Ref. 32). Full Text in PDF www.elis.sk. Key words: primary obstructed megaureter, cystouretography, hydronephrosis, kidney function, normal ureter. This prospective study with systematically examined consecutive patients by a created protocol for both of the groups was aimed to compare surgical and conservative treatment of the primary obstructive megaureter (POM) in selected group of children. We present our view on the issue and the results of treatment in different groups of patients. Materials and methodsIn the Department of Urology in the Louis Pasteur University Hospital in Košice, between the years 2000-2009, we were treating 45 patients (52 ureters) with POM diagnosis. Patients' ages ranged between 1-63 months with the average of 5.8 months (±10.33). The clinical group was divided into the two groups according to the entrance criteria -that is group I -patients who were operated on and group II non-operated patients. We created a protocol for both of the groups on the basis of which we prospectively examined the patients, we were observing them and we evaluated the outcomes of the treatment. Within the methodology, we performed examination of the urine and urinary sediments, bacteriological examination of urine, in order to indicate the degree of dilatation of hydronephrosis and the width of the megaureter by USG of the kidneys and ureter, DTPA 99mTc with the application of furosemide in order to detec...

Febrile Urinary Tract Infections in Children with Primary Non-Refluxing Megaureter: A Systematic Review and Meta-Analysis

“…This observation corresponds to the findings in children with antenatal hydronephrosis [8]. Notwithstanding, it remains open whether the grade of dilatation of the hydroureteronephrosis may be the determining factor for developing fUTI or the presumably associated distal ureteral outflow impairment [3,38,52]. However, patients with more dilated PM and higher grade of hydronephrosis were often not eligible for non-surgical management even though evidence of urinary outflow obstruction by functional imaging was not always given [3,34,43,46,48].…”