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Primary obstructive megaureter.

V Sripathi1, P A King, M R Thomson

  • 1Department of Surgery, Princess Margaret Hospital for Children, Perth, Australia.

Journal of Pediatric Surgery
|July 1, 1991
PubMed
Summary
This summary is machine-generated.

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Surgical treatment for primary obstructive megaureters in children, involving transvesical excision and reimplantation, led to successful outcomes in many cases, with significant improvements in renal function and ureteric size. However, some patients experienced postoperative infections or complications like obstruction and reflux.

Area of Science:

  • Pediatric Urology
  • Surgical Innovation
  • Renal Physiology

Background:

  • Primary obstructive megaureters present a significant challenge in pediatric urology.
  • Urinary tract infections are a common presenting symptom in affected children.
  • Histopathological findings reveal characteristic fibromuscular abnormalities in the ureteral wall.

Purpose of the Study:

  • To evaluate the long-term outcomes of surgical management for primary obstructive megaureters in children.
  • To assess the efficacy of transvesical excision and antireflux reimplantation.
  • To identify factors influencing postoperative success and complications.

Main Methods:

  • Retrospective analysis of 23 children (28 ureters) treated between 1978-1988.
  • Surgical technique involved transvesical excision of the obstructive ureteral segment.

Related Experiment Videos

  • Ureters were tapered and reimplanted using an antireflux technique.

    • Main Results:

    • Seven children demonstrated excellent outcomes: renal growth, reduced ureteric size, improved glomerular filtration rate, no obstruction, and no infections.
    • Four children achieved similar functional improvements but experienced postoperative infections.
    • Six children experienced complications, including postoperative obstruction (3) and vesicoureteric reflux (3).

    Conclusions:

    • Transvesical excision and antireflux reimplantation are effective treatments for primary obstructive megaureters.
    • While most patients show significant functional improvement, careful monitoring for infections and complications is essential.
    • Further research may explore strategies to minimize postoperative morbidity.