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[Primary and secondary megaureter in children. Indication and results of surgical correction]
Abstract:
Fifty-two children with 63 renoureteral units were treated for primary megaureter (p.m.) and 62 children with 102 renoureteral units for secondary megaureter (s.m.) due to infravesical obstruction. The changing concepts of diagnosis and therapy in 3 periods influenced both the indication for ureteroneocystostomy (p.m.: 79%, 63%, 58%; s.m.: 71%, 30%, 31%) and the rate of good results of operation (p.m.: 63%, 80%, 76%; s.m.: 44%, 78%, 81%), the criteria for good results being no infection, no reflux, no dilatation. Extensive diagnostic studies are necessary to avoid false indications with consequent poor therapeutic results. In cases of incidentally diagnosed primary megaureter without symptoms conservative treatment or "watchful waiting" is justified.