The utilization of stents in the management of primary obstructive megaureters requiring intervention before 1 year of age.
OBJECTIVE
To analyse the long-term outcome of 16 infants with primary obstructive megaureter managed by (endoscopic or open) stenting over a 10-year period.


METHODS
A retrospective case-note and imaging review was performed between 1997 and 2007. Data are presented as medians (range) and were compared using the Mann-Whitney test.


RESULTS
Sixteen infants with 19 obstructed megaureters were stented at a median age of 24 weeks, for a median of 6 months. One-third of stents were inserted endoscopically. Complications (stent migration, stone formation or infection) occurred in 31.6%. One infant was excluded due to a co-existent pelviureteric junction obstruction. Drainage improved in 10 ureters (56%) following stent removal. Of the remaining renal units, 6 were reimplanted, and 2 underwent a nephrectomy due to deterioration in renal function following stent removal. Resolution of the vesicoureteric junction obstruction occurred in 4 of 6 infants following endoscopic stent insertion, and in 6 of 12 infants following open stent insertion (P=0.60). There was no difference in the length of time that ureters were stented in the resolved (7.5 (6-15) months) versus the reimplanted (6.0 (1-18) months) group (P=0.13).


CONCLUSIONS
Of obstructive megaureters managed by stenting for a median of 6 months, 56% did not require further surgery. However, morbidity occurred in one third of patients, and function deteriorated after removal of stent in two patients who later required a nephrectomy.
Farrugia
Marie-Klaire
MK
Department of Paediatric Urology, Southampton University Hospital Trust, Southampton SO16 6YD, UK. mkfarrugia@doctors.org.uk
Steinbrecher
Henrik A
HA
Malone
Padraig S
PS
D004322:Drainage; D006801:Humans; D006869:Hydronephrosis / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*; D007223:Infant; D009392:Nephrectomy; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome; D014463:Ultrasonography; D014513:Ureter / Q000000981:diagnostic imaging / Q000473:pathology*; D014517:Ureteral Obstruction / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*