R zubieta a, r castillo g, jm escala a, m varela a. A megaureter refers to an expanded or widened ureter that does not function normally. A megaureter is a ureter that is much wider than normal. Although rare, primary megaureter is responsible for up to 20% of hydronephrosis cases in neonates. To describe a new approach to the treatment of primary obstructive megaureter pomu using endoscopic endoureterotomy. Primary obstructive megaureter is an uncommon disease in adults. Megaureter, the accepted term for the dilated ureter, is divided into primary congenital and secondary categories. If primary megaureter was identified, after 1 month the children underwent 99tmdmsa, diuretic 99tmdtpa, and intravenous urography. Primary megaureter detected by prenatal ultrasonography. The ureteral caliber can be reduced by excising the distal redundant ureter hendren technique or plication kalicinski technique, starr technique to achieve a satisfactory antireflux mechanism. 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. Teklali praticien hospitalier, chirurgie pediatrique. Tratamiento del megaureter congenito obstructivo primario.
A left ureterolithotomy, left nipple ureteroneocystostomy, and psoas hitch operation was. Megaloureter definition of megaloureter by medical. The primary obstructive megaureter is caused by a prevesical aperistaltic ureter segment, which causes a dilatation of the prestenotic ureter. Congenital giant megaureter cgm is an extremely rare condition, which is defined as the lumen of a ureter is congenitally, focally and segmentally dilated to more than 10 times of the normal diameter, in presence of normal bladder volume and function. The megaureter can be mobilized via an intravesical, extravesical, or combined approach. Pdf reflujo vesicoureteral secundario al tratamiento endoscopico. Congenital megaureter is an uncommon condition which is more common in males, may be bilateral, and is often associated with other congenital anomalies. She hoped for surgical intervention before becoming pregnant. The differential diagnosis of anh, in order of likelihood, includes transient primary hydronephrosis, ureteropelvic junction obstruction upjo, vesicoureteric reflux vur, ureterovesical junction obstruction uvjo or primary nonobstructive megaureter, ureterocele. Megaureter is a medical anomaly whereby the ureter is abnormally dilated.
Since then, a small number of patients with cgm have been reported. Eight infants with primary megaureter bilateralin 3 cases were identified, for a total of 11 renal units for study. Or your child may also have imaging tests to look at the urinary tract. Ureters are the two funnelshaped tubes that carry urine from the kidneys to the bladder. A megaureter means big ureter and is a descriptive term, not a diagnosis. Malformaciones urogenitales 2011 linkedin slideshare. Goslingthe vesicoureteric junction in three cases of primary obstructive megaureter associated with. The cause is thought to be aperistalsis of the distal ureter, leading to dilatation the cutoff value for megaureter is when it is wider than 6 or 7 mm. Megaureter knowledge for medical students and physicians. Uma conversa franca com os candidatos a fe em jesus, 1. Renal function and urine drainage after conservative or.
We examined renal function and urinary drainage of children with primary megaureter pmu in dependence on conservative or operative treatment. 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 download pdf. Laparoscopic nephroureterectomy for adult patient with. Megaureter and other congenital ureteral anomalies. A 29yearold female with a complaint of abdominal distension was referred to our hospital. Often it is diagnosed by ultrasound while a woman is still pregnant. The first cgm was reported by chaterjee sk in 1964.
Megaureter is an abnormality of one or both of the ureters of a child. Totally laparoscopic repair of primary obstructive. These are the options to access the full texts of the publication actas. A 19yearold male patient was admitted with flank pain, which had lasted intermittently for four years.
Primary megaureter is due to obstructed or refluxing vesicoureteral junction, while secondary megaureter is caused by bladder outlet obstruction. Endoureterotomy for treatment of primary obstructive. Primary obstructive megaureter with giant ureteral stone. Each category is further subdivided into 1 refluxing nonobstructing megaureter and 2 nonrefluxing obstructing megaureter. Megaureter primario no refluyente detectado prenatalmente. Puede ser obstructivo, secundario a reflujo o no obstructivo. These distinctions are based on radiographic and clinical findings. Megaureter des oberpolsystems bei einer doppelniere rechts. A megaureter is an anomaly with a dilated ureter of more than 78 mm, the further division is made according to the cause.
Megaureter geralmente diagnosticada por ultrasomfeto. The anomaly is often associated with other defects or anomalies. Megaureter is defined as a ureter that exceeds the upper limits of normal size. The two important questions about megaureter are whether there is reflux backwash of urine causing the megaureter or whether there is blockage at the. A megaureter large ureter is when a ureter is wider than threeeighths of an inch. By computed tomography and retrograde pyelography, she was diagnosed with adult left primary megaureter. If there is reflux, the diagnosis is refluxing megaureter or megaureter. The size of a megaureter is usually greater than 7. The different types of megaureters are described below. Megaureter article about megaureter by the free dictionary. A rare condition where the patient is born with an abnormally dilated ureter. A ureter that is wider than 38 inch is a megaureter. About half of the patients with megaureter are asymptomatic. This can result from an abnormality of the ureter itself primary or from the bladder being blocked secondary.
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