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Management of primary megaureter in infancy
1Department of Pediatric Surgery, Policlinico Umberto I Università di Roma, La Sapienza, Italy.
Journal of Pediatric Surgery
|August 1, 1993
Summary
Many infants with primary megaureter, a condition causing ureteral dilation, show spontaneous improvement. Conservative management is often effective for asymptomatic cases, avoiding unnecessary surgery.
Area of Science:
- Pediatric Urology
- Nephrology
- Medical Imaging
Background:
- Primary megaureter is a congenital condition affecting the ureter.
- It is often diagnosed prenatally via ultrasound.
- Associated findings include pelvicaliceal dilatation.
Purpose of the Study:
- To evaluate the natural history of nonrefluxing primary megaureter in infants.
- To determine the efficacy of conservative management versus surgical intervention.
- To identify predictors for spontaneous resolution.
Main Methods:
- Retrospective analysis of 26 infants with 38 primary megaureters.
- Utilized prenatal ultrasound and Diethylene Triamine Pentaacetic Acid (DTPA) scanning for renal function assessment.
- Conservative management was employed for asymptomatic cases with good differential renal function.
Main Results:
- Twenty out of 26 infants experienced partial or complete regression of ureteral dilatation.
- Renal function remained stable in most conservatively managed patients.
- Surgical intervention was reserved for cases with urinary tract infection or significant renal function decline.
Conclusions:
- Asymptomatic primary megaureter in infancy frequently exhibits spontaneous improvement.
- Conservative management is a viable option for select cases, reducing the need for surgery.
- Monitoring renal function is crucial for guiding treatment decisions.