Primary obstructive megaureter.
Twenty-three children with primary obstructive megaureters presented between 1978 and 1988 to the Princess Margaret Hospital for Children in Perth. Twenty-eight ureters were treated. Urinary infections were the presenting feature in 14 children. The obstructive segment was transvesically excised. Histopathologic examination of the distal, intramural ureter showed fibromuscular disarray with a relative increase in fibrous tissue and reduction of musculature in all specimens. Twenty-two ureters were tapered by excision and all 28 were reimplanted using an antireflux technique. Seventeen children were followed for an average of 3 years. Seven children showed renal growth, reduction in ureteric size by greater than 2 cm, improvement in glomerular filtration rate by more than 10%, no obstruction on reflux, and no infections in postoperative period. Four children showed all the above but suffered one or more infections after the operation. Of the remaining 6 children, 3 had postoperative obstruction and 3 had vesicoureteric reflux.
Sripathi
V
V
Department of Surgery, Princess Margaret Hospital for Children, Perth, Australia.
King
P A
PA
Thomson
M R
MR
Bogle
M S
MS
D002648:Child; D002675:Child, Preschool; D004322:Drainage; D004927:Escherichia coli Infections / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009403:Nephrostomy, Percutaneous; D011704:Pyelonephritis / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D012092:Replantation; D014513:Ureter / Q000002:abnormalities* / Q000473:pathology / Q000601:surgery; D014517:Ureteral Obstruction / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery