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Long-term follow up of antenatally diagnosed megaureters

Boris Chertin1, Avner Pollack, Dmitry Koulikov

  • 1Department of Urology, Shaare Zedek Medical Center, Faculty of Medical Science, Hebrew University, Jerusalem, Israel. bchertin@yahoo.com

Journal of Pediatric Urology
|July 18, 2008
PubMed

Insights

Only 30% of children diagnosed with antenatal hydronephrosis leading to megaureter required surgery. Key surgical indicators include poor renal function (less than 30%), severe hydronephrosis (SFU grades 3-4), and ureteral diameter over 1.33 cm.

Area of Science:

  • Pediatric Urology
  • Fetal Medicine
  • Nephrology

Background:

  • Antenatal hydronephrosis is a common finding in fetal ultrasounds.
  • Megaureter, a condition where the ureter is abnormally enlarged, can result from antenatal hydronephrosis.
  • Determining the need for surgical intervention in pediatric megaureter cases is crucial for optimal outcomes.

Purpose of the Study:

  • To evaluate the long-term surgical outcomes of antenatal hydronephrosis leading to postnatal megaureter.
  • To identify specific criteria that predict the necessity of surgical correction in affected children.

Main Methods:

  • Retrospective analysis of 79 children with antenatal hydronephrosis and postnatal megaureter over 18 years.
  • Conservative management was employed, with surgery indicated by specific functional and imaging criteria.
  • Utilized Society for Fetal Urology (SFU) classification for grading hydronephrosis and assessed relative renal function.

Main Results:

  • 31% of children required surgical correction, with a mean age of 14.3 months at the time of surgery.
  • Significant independent risk factors for surgery included SFU grade 3-4 hydronephrosis, relative renal function below 30%, and ureteral diameter exceeding 1.33 cm.
  • Gender and laterality of obstruction were not significant predictors for surgical intervention.

Conclusions:

  • A minority of children (30%) with antenatal diagnosis of megaureter necessitate surgical intervention.
  • Preoperative assessment of renal function, hydronephrosis severity (SFU grade), and ureteral diameter are vital for surgical decision-making.
  • Established criteria can reliably predict which pediatric megaureter cases require surgical correction.
Abstract

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