[Optimization of diagnostic and therapeutic tactics for primary megaureter in children]

Obstructive megaureter (MU) and refluxing MU were treated in 2000-2004 in 580 and 711 children, respectively. This number was by 18.9% higher than in 1990-1994. Out of 1291 children with MU, two groups of patients were singled out: group 1 with primary obstructive MU (n = 158) and group 2 with primary refluxing MU (n = 185). In patients of groups 1 and 2 the following operations were made: ureteral reimplantation (n = 126), Koen's operation (n = 104), Politano-Leadbetter operation (n = 12), Lich-Greguaru operation (n = 8), nephrureterectomy (n = 32), heminephrureterectomy (n = 27), transurethral dissection of ureterocele (n = 8), other in 26 patients. A great number of primary nephrureterectomies evidence for frequent morphofunctional immaturity of one of the kidneys in children with primary MU forms. The 1.5-6 year follow-up results were good in 85.4% children of group 1 and 94.1% children of group 2. In planning follow-up and assessing long-term follow-up results morphofunctional state of the kidney and ureter before and after operation must be considered according to the following main criteria: dilation of the caliceal-pelvic system and ureter, renal function, pyelonephritis activity, the presence or absence of recurrent stricture of the distal ureteric segment or the presence of vesicoureteral reflux.