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Primary obstructive megaureter in adults: need for an aggressive management strategy
L N Dorairajan1, A K Hemal, N P Gupta
1Department of Urology, All India Institute of Medical Sciences, New Delhi.
International Urology and Nephrology
|February 7, 2001
Summary
Adults with primary obstructive megaureter (POM) often present with symptoms and complications like stones and renal failure. Early surgical correction, such as ureteric re-implantation, is effective and recommended for better outcomes.
Area of Science:
- Urology
- Pediatric Urology
- Adult Urology
Background:
- Primary obstructive megaureter (POM) is a rare condition in adults.
- Adult presentation often involves significant symptoms and complications.
Purpose of the Study:
- To review the clinical profile, management strategies, and prognosis of adult patients diagnosed with POM.
- To identify common complications and assess treatment outcomes in this demographic.
Main Methods:
- Retrospective study of 37 adult patients with POM diagnosed between January 1989 and December 1998.
- Analysis of clinical presentation, renal function, radiological findings, complications, treatments, and follow-up data.
Main Results:
- Patients aged 13-52 years, with a male:female ratio of 27:10. Seven had bilateral disease.
- Common complications included loin pain (26), urinary infection (15), and calculus disease (17). Five patients presented with azotaemia.
- Surgical intervention was required for 34 patients, with ureteroneocystostomy (UNC) being the most common procedure (26).
Conclusions:
- Most adult POM patients are symptomatic and require surgical intervention.
- Stone formation and renal failure are frequent complications in adults with POM.
- Early diagnosis and treatment are crucial; ureteric re-implantation offers effective management with low morbidity.