Ureterovesical Junction Anomalies: Megaureters

Does the Nipple Valve Ureteral Reimplantation Work in Infants?

“…As such, there was little concern for dissection around the ureter opening that is too close to the bladder neck in a small bladder [5]. The small difference between our technique from the refluxing ureteral reimplatation [9] is the nipple inside the bladder.…”

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Ureteral reimplantation with or without tapering is a common procedure in pediatric urology for obstructed megaureter. However, as for under one year old children, besides support opinions [1][2][3][4], there is no consensus about these conventional reimplantations because they could cause ureteral stenosis, even permanent neurologic lesions [5,6]. In the surgical treatment of obstructed megaureter, to avoid these complications, some other techniques may be used as temporary procedures, such as double J ureteral stenting [7], cutaneous ureterostomy [8], temporary refluxing ureteral reimplantation [9,10], while waiting for bladder growth when conventional reimplantation can safely be performed.

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Tapering of the Megaureter

“…The term ‘megaureter’ describes a grossly dilated ureter comprising a wide spectrum of anomalies associated with an increased ureteric diameter . Cussen showed in autopsy studies, that a normal ureter in children usually has a diameter of <5 mm.…”

“…If surgical intervention is indicated, ureteric reimplantation can be performed by either intravesical, extravesical or combined intra‐ and extravesical techniques . Using the ‘Psoas Hitch’ technique, ureteric tailoring is not required in most cases when a less dilated middle third of the ureter is mobilised and reimplanted into an appropriate submucosal tunnel.…”

Πολυμορφισμός Του Γονιδίου Του Μετατρεπτικού Ενζύμου Της Αγγειοτενσίνης Και Ο Ρόλος Του Στην Ανάπτυξη Συγγενών Διαμαρτιών Του Ουροποιητικού

“…Μεγαουρητήρας µπορεί να αποκαλυφθεί σε ποικίλες ουρολογικές κλινικές οντότητες. ∆ιακρίνονται 3 κατηγορίες: α) αποφρακτικός µεγαουρητήρας, β) παλινδροµών µεγαουρητήρας και γ) µη αποφρακτικός -µη παλινδροµών µεγαουρητήρας 216,274,277. Ο πρωτοπαθής µη αποφρακτικός -µη παλινδροµών µεγαουρητήρας θεωρείται ήπια παραλλαγή του αποφρακτικού.…”