[Secondary obstructive megaureter with detrusor-sphincter dyssynergia in children]

29 boys with secondary obstructive megaureter due to detruzor-sphincter dyssinergy were treated in 1989-1998. To normalize detruzor-sphincter relations, transurethral sphincterotomy was made in 25 boys. Later, 16 of them underwent autocatheterization of the urinary bladder and received alpha-adrenoblockers. Reconstructive plastic operations were performed in 34.5% (secondary megaureter of the degree III-IV). The author thinks more valid not to use the term "secondary obstructive megaureter" but to integrate this compound urinary tract lesion (megaureter with dyssinergy associated with diffuse dysplastic changes in the kidneys) into one syndrome. In secondary megaureter, longitudinal ureteral modelling is valid as this facilitates its reimplantation. Urodynamic examinations of the lower urinary tracts showed that sphincterotomy reestablished micturition in many cases, though high miction and intraabdominal pressure in dysadaptation of detruzor evidences for the existence of detruzor-sphincter dyscoordination in latent denervation of the urinary bladder.