Endoureterotomy for congenital primary obstructive megaureter: preliminary report

Area of Science:

• Urology
• Minimally Invasive Surgery

Background:

• Congenital obstructive megaureter (COMU) can lead to significant kidney damage and complications like stones if untreated.
• Traditional surgical management involves ureteral reimplantation, a more invasive procedure.

Purpose of the Study:

• To evaluate the safety and efficacy of endoureterotomy as a treatment for congenital obstructive megaureter in adult patients.
• To adapt the principles of endopyelotomy for managing COMU.

Main Methods:

• Endoureterotomy was performed on six ureters in five adult patients.
• The procedure involved cystoscopic evaluation, guidewire insertion, ureteral dilation, and endoscopic incision of the obstructed ureteral segment.
• A double-J stent was placed for three weeks post-procedure.

Main Results:

• Follow-up of 1 to 4 years demonstrated successful urine drainage into the bladder.
• Patients experienced a significant reduction in proximal ureteral stasis.
• Recurrent infections and pain were eliminated.

Conclusions:

• Endoureterotomy appears to be a safe and effective treatment option for congenital obstructive megaureter.
• Despite a small series and short follow-up, results suggest a promising alternative to open surgery.