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Related Experiment Videos

Primary obstructive megaureter in adults.

M K Hanna, J K Wyatt

    The Journal of Urology
    |March 1, 1975
    PubMed
    Summary
    This summary is machine-generated.

    Primary obstructive megaureter in adults can be asymptomatic, leading to kidney damage. Early diagnosis and surgical intervention, like ureteral remodeling and reimplantation, are crucial for preserving kidney function.

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    Area of Science:

    • Urology
    • Nephrology
    • Pediatric Surgery

    Background:

    • Primary obstructive megaureter (POM) is a congenital condition often diagnosed in childhood, but can present in adults.
    • Adult presentation of POM may be subtle, potentially leading to delayed diagnosis and irreversible kidney damage.
    • Understanding the adult clinical spectrum and pathological basis of POM is essential for effective management.

    Purpose of the Study:

    • To review the clinical features, diagnosis, and treatment of 26 adult patients with primary obstructive megaureter.
    • To discuss the histological findings and urodynamic characteristics of adult POM.
    • To evaluate the outcomes of conservative and surgical management strategies for adult POM.

    Main Methods:

    • Retrospective review of 26 adult patients diagnosed with primary obstructive megaureter.

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  • Analysis of clinical presentation, diagnostic imaging (including high-dosage cine-pyelography), histological findings, and urodynamic studies.
  • Evaluation of treatment outcomes, including conservative management and surgical interventions such as ureteral remodeling and reimplantation.

    • Main Results:

    • Two kidneys were lost due to progressive disease in asymptomatic patients, highlighting the potential for silent progression.
    • Urodynamic studies suggest a low resting pressure but limited reserve capacity, predisposing to renal atrophy under increased urine production.
    • Radiological features, specifically bulb-and-tail versus sharp cutoff, correlated with disease course.
    • Fifteen of 26 patients ultimately required surgery, with 11 achieving gratifying results after ureteral remodeling and reimplantation.

    Conclusions:

    • Adult primary obstructive megaureter can present insidiously with severe consequences, including renal destruction.
    • Urodynamic assessment provides insights into the functional status and potential risks of renal damage.
    • Surgical intervention, particularly ureteral remodeling and reimplantation, is recommended for symptomatic cases, those with calculi, or planned pregnancy, offering favorable outcomes.