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Ureters01:22

Ureters

The ureters are retroperitoneal tubes located on either side of the vertebral column. They are responsible for transporting urine from each kidney to the urinary bladder. These tubes have thick walls and are approximately 25-30 cm long. Their diameter is around 10 mm at the renal pelvis, gradually narrowing to 1 mm as the ureter obliquely enters the posterior bladder wall through the ureteric orifices. The shape of these orifices is slit-like, which helps to prevent urine backflow toward the...
Imaging Studies V: Intravenous Urography and Retrograde Pyelography01:22

Imaging Studies V: Intravenous Urography and Retrograde Pyelography

IntroductionIntravenous Urography (IVU) and Retrograde Pyelography (RP) are important diagnostic imaging techniques used to evaluate the urinary system. These methods help identify structural abnormalities, obstructions, and functional issues in the kidneys, ureters, and bladder. Both procedures use iodine-based contrast media to enhance the visibility of urinary tract structures on X-ray images, though they differ in their methods and indications.1. Intravenous Urography (IVU)Intravenous...
Urinary Tract Calculi VI: Surgical Management01:25

Urinary Tract Calculi VI: Surgical Management

Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...
Acute Pyelonephritis I: Introduction01:27

Acute Pyelonephritis I: Introduction

Pyelonephritis is a bacterial infection that primarily affects the renal parenchyma and collecting system, including the renal pelvis, tubules, and interstitial tissue of one or both kidneys. It can be classified as either acute—a sudden, severe infection—or chronic, which refers to long-term or recurrent kidney infections.The primary cause of acute pyelonephritis (APN) is bacterial infection, with Escherichia coli accounting for approximately 70-80% of cases. Other bacteria, such as Proteus,...
Anatomy of the Genitourinary System I: Kidneys and Ureters01:11

Anatomy of the Genitourinary System I: Kidneys and Ureters

The upper urinary system comprises two kidneys and two ureters, which are crucial in filtering blood and forming urine.KidneysLocation and Structure:The kidneys are two bean-shaped organs positioned behind the peritoneum on either side of the spine.Kidneys are between the 12th thoracic (T12) and the 3rd lumbar (L3) vertebrae.The position of the liver causes the right kidney to sit slightly lower than the left.Protective Layers:Each kidney is enveloped in a tough, fibrous membrane called the...
Urinary Bladder01:23

Urinary Bladder

The urinary bladder is a hollow, muscular sac that temporarily stores urine before it is expelled from the body. It can hold approximately 600 mL of urine prior to micturition. The bladder is retroperitoneal and located behind the pubic symphysis in the pelvic floor.
In males, the bladder is situated in front of the rectum, while in females, it is positioned anterior to the vagina and uterus. The bladder floor contains an inverted triangular area called the trigone, defined by the two ureteric...

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Related Experiment Video

Updated: Jun 28, 2026

Transmesenteric Laparoscopic Pyeloplasty in Trendelenburg Position for Horseshoe Kidney with Hydronephrosis
03:57

Transmesenteric Laparoscopic Pyeloplasty in Trendelenburg Position for Horseshoe Kidney with Hydronephrosis

Published on: July 8, 2025

Primary non-refluxing megaureters.

E Merlini1, P Spina

  • 1Department of Paediatric Surgery, Ospedale Maggiore della Carità Hospital, Corso Mazzini 18, 28100 Novara, Italy. emilio.merlini@maggioreosp.novara.it

Journal of Pediatric Urology
|October 25, 2008
PubMed
Summary

Primary megaureters, a cause of hydronephrosis, often resolve on their own. However, some cases require surgical intervention to preserve kidney function.

Area of Science:

  • Pediatric Urology
  • Nephrology

Background:

  • Megaureters, characterized by ureteral dilation, can be primary or secondary, stemming from obstruction, reflux, or other causes.
  • Primary obstructed megaureter is linked to an aperistaltic and narrowed ureter segment, with specific changes in smooth muscle and collagen.
  • Primary non-refluxing megaureters account for 23% of prenatal hydronephrosis diagnoses, predominantly in males and on the left side.

Purpose of the Study:

  • To describe the etiology, diagnosis, and management of primary megaureters.
  • To outline the natural history and surgical indications for primary megaureters.

Main Methods:

  • Review of diagnostic workup including ultrasound, micturating cystourethrogram, and isotopic renogram.
  • Analysis of spontaneous regression, stability, and need for surgical intervention.

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Technical Modification of the Terminal Ureter During Total Transperitoneal Laparoscopic Nephroureterectomy for Upper Urinary Tract Urothelial Carcinoma
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Technical Modification of the Terminal Ureter During Total Transperitoneal Laparoscopic Nephroureterectomy for Upper Urinary Tract Urothelial Carcinoma

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  • Description of surgical principles for primary megaureters.
  • Main Results:

    • Most primary megaureters exhibit spontaneous regression or stability without impacting renal function.
    • A minority (10-25%) necessitate surgery due to declining renal function, progressive dilation, or symptomatic presentation.
    • Surgical repair involves resecting the obstructing segment, ureteral size reduction, and anti-reflux reimplantation.

    Conclusions:

    • Primary megaureters have a variable natural history, with many cases resolving spontaneously.
    • Timely diagnosis and monitoring are crucial to identify cases requiring surgical management.
    • Surgical techniques aim to restore normal ureteral function and prevent reflux.