[Optimization of diagnostic and therapeutic tactics for primary megaureter in children].
Obstructive megaureter (MU) and refluxing MU were treated in 2000-2004 in 580 and 711 children, respectively. This number was by 18.9% higher than in 1990-1994. Out of 1291 children with MU, two groups of patients were singled out: group 1 with primary obstructive MU (n = 158) and group 2 with primary refluxing MU (n = 185). In patients of groups 1 and 2 the following operations were made: ureteral reimplantation (n = 126), Koen's operation (n = 104), Politano-Leadbetter operation (n = 12), Lich-Greguaru operation (n = 8), nephrureterectomy (n = 32), heminephrureterectomy (n = 27), transurethral dissection of ureterocele (n = 8), other in 26 patients. A great number of primary nephrureterectomies evidence for frequent morphofunctional immaturity of one of the kidneys in children with primary MU forms. The 1.5-6 year follow-up results were good in 85.4% children of group 1 and 94.1% children of group 2. In planning follow-up and assessing long-term follow-up results morphofunctional state of the kidney and ureter before and after operation must be considered according to the following main criteria: dilation of the caliceal-pelvic system and ureter, renal function, pyelonephritis activity, the presence or absence of recurrent stricture of the distal ureteric segment or the presence of vesicoureteral reflux.
Iushko
E I
EI
Strotskiĭ
A V
AV
Skobeius
I A
IA
Gerasimovich
A I
AI
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D014515:Ureteral Diseases / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery*; D014517:Ureteral Obstruction / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D014563:Urodynamics; D013520:Urologic Surgical Procedures / Q000379:methods*; D014718:Vesico-Ureteral Reflux / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery