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Published on: July 8, 2025
Primary non-refluxing megaureter: need for conservative treatment.
D Antoniou1, N Baltogiannis, M Soutis
1Department of Pediatric Surgery II, Aghia Sophia Children's Hospital, Athens, Greece. dcantoniou@mailbox.gr
Summary
Conservative management is effective for asymptomatic primary non-refluxing megaureter. Most cases show spontaneous resolution or improvement, with surgery reserved for severe hydroureteronephrosis.
Area of Science:
- Pediatric Urology
- Nephrology
Background:
- Primary non-refluxing megaureter is a congenital condition affecting the ureter.
- Many cases of ureteral dilatation resolve spontaneously, and conservative treatment is often effective in asymptomatic patients.
Purpose of the Study:
- To report the experience with conservative treatment of primary non-refluxing megaureter in 108 patients.
- To discuss the long-term outcomes of non-surgical management.
Main Methods:
- Patients were evaluated using ultrasound (US), voiding cystourethrogram (VCUG), and MAG3 renography.
- The observation period ranged from 6 to 72 months (mean 29.1 months).
Main Results:
- Surgery was performed in 11.1% of patients with severe hydroureteronephrosis.
- Complete resolution or significant improvement was observed in 74% of cases.
- Megaureters graded 1 to 3 showed a tendency to resolve between 12 and 36 months.
Conclusions:
- Conservative management is the preferred treatment for primary non-refluxing megaureter.
- The grade of hydroureteronephrosis is a key predictor of outcomes.
- Regular follow-up with renal ultrasound and diuretic renography is recommended for infants.
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