Is There a Consensus on the Management of Primary Obstructive Megaureter?

Area of Science:

• Pediatric Urology
• Surgical Innovation
• Medical Diagnostics

Background:

• Primary obstructive megaureter (POM) management guidelines were established by the British Association of Pediatric Urologists in 2014.
• Expert consensus on current diagnostic and therapeutic strategies for POM is evolving.

Purpose of the Study:

• To survey expert opinions on primary obstructive megaureter (POM) diagnosis and management.
• To compare current expert practices with 2014 British Association of Pediatric Urologist recommendations.

Main Methods:

• An online survey was distributed to pediatric urologists via the eUROGEN network and societies.
• The survey comprised 14 questions, with data collected from February to June 2023.
• A literature review supplemented the survey data.

Main Results:

• 103 professionals (96.1% pediatric urologists) responded.
• 67.3% favored continuous antibiotic prophylaxis for POM.
• Diagnosis often combines DRF, serial scan changes, and ultrasound findings; 11.9% would operate on isolated initial DRF <40%.

Conclusions:

• Current POM management trends may diverge from 2014 BAPU guidelines.
• Expert opinion suggests a need for updated consensus on POM diagnosis and surgical indications.
• High-pressure endoscopic balloon dilatation is a favored temporizing intervention.