Can endoscopic balloon dilation for primary obstructive megaureter. Megaureteres, estudio y conducta medica scielo infomed. One of the female patients with a prenatal diagnosis of megaureter presented a febrile urinary tract infection at 4 months old and one month later underwent rightsided endoscopic ureterovesical dilation and a double j stent was inserted, with no improvement on the ultrasound. About half of the patients with megaureter are asymptomatic. Prenatal detection of primary nonrefluxing megaureter.
A section of the terminal was made,ureteroplastia of an 810 cm of. In children, any ureter greater than 7 mm in diameter is considered a megaureter based on measurements in fetuses greater than 30 weeks gestation and children pdf background. A 15yearold male presented with obstructive megaureter. Sometimes the reflux and stretched ureters gets better over the first year of life. A refluxing megaureter is a sign of vesicoureteral reflux. The different types of megaureters are described below. If there is reflux, the diagnosis is refluxing megaureter or megaureter. This can result from an abnormality of the ureter itself primary or from the bladder being blocked secondary. A megaureter large ureter is when a ureter is wider than threeeighths of an inch.
A read is counted each time someone views a publication summary such as the title, abstract, and list of authors, clicks on a figure, or views or downloads the fulltext. Tratamiento del megaureter congenito obstructivo primario. Laparoscopic ureterovesical repair for megaureter treatment. Primary megaureter is due to obstructed or refluxing vesicoureteral junction, while secondary megaureter is caused by bladder outlet obstruction. The standard threeport transperitoneal pyeloplasty technique and an additional 5mm port for dynamic traction were used. Almost onequarter of the children referred to a pediatric urologist for obstructive uropathy suffer from an obstructive megaureter. Conclusion laparoscopic pyeloplasty, intracorporeal excisional tailoring, and nonrefluxing reimplantation are safe and effective for the treatment of obstructive congenital megaureter. Congenital anomalies of the kidneys and urinary tract can be detected in 1 of every 500 ultrasonographic fetal examinations. Megaureter primario no refluyente detectado prenatalmente anales. The ureter is too narrow where it enters the bladder, causing a blockage of urine flow at that point. The procedure consisted in incising the stenotic portion of the ureter longitudinally and. Endoscopic balloon dilatation in primary obstructive megaureter.
The patient was considered carrier of this last pathology taking into account the antecedents and the presentation of her clinic episode which was confirmed in the surgery and in the medical check of the fragment of the urether. In this type, the urine flows back up the ureter from the bladder. This backflow, known as vesicoureteral reflux, expands the ureter. The initial medical behavior was conservative in all of cases, but it was surgical. The two important questions about megaureter are whether there is reflux backwash of urine causing the megaureter or whether there is blockage at the ureterovesical junction causing megaureter figure 1. A megaureter means big ureter and is a descriptive term, not a diagnosis. Pelvic and ureteral dissection, pyeloplasty, intracorporeal excisional ureteral tailoring and nonrefluxing ureteroneocystostomy were all completed laparoscopically. An alternative treatment for obstructive and refluxing obstructive megaureter with ureterovesical junction maintenance through. Megaureter knowledge for medical students and physicians. Although rare, primary megaureter is responsible for up to 20% of hydronephrosis cases in neonates. Megaureter is defined as a ureter that exceeds the upper limits of normal size. The two most common types of megaureter by far are the primary nonobstructed megaureter and the refluxing. Between 1974 and 1991, 46 patients with primary obstructive megaureter pom were sur gically treated.
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