ESPN 51th Annual Meeting

ESPN 2018


 
Clinical and radiological course of children with non-refluxing non-obstructive megaureter
MERAL TORUN BAYRAM 1 HÜSNE DIDEM TÜRKER 1 ALPER SOYLU 1 SALIH KAVUKÇU 1

1- DOKUZ EYLUL UNIVERSITY MEDICAL FACULTY, DEPARTMENT OF PEDIATRICS, IZMIR, TURKEY
 
Introduction:

 

A megaureter is a descriptive term meaning large ureter and is diagnosed by ultrasound. Megaureters can be classified as obstructed, refluxing, obstructed and refluxing, or neither obstructing nor refluxing. We aimed to evaluate the outcomes of children with non-refluxing non-obstructive (NONR) megaureter. 

Material and methods:

Hospital files of the children with NONR megaureter were evaluated retrospectively for age at diagnosis, presenting complaint, follow-up period, accompanying urologic abnormalities, complications (renal scar and urinary tract infection) and final status.

Results:

NONR megaureter was detected in 33 (25 male) patients and 36 renal units (3 bilateral). Mean age at diagnosis was 11.6±19.4 (0-72) months and mean follow-up period was 36.7±36.6 (12-72) months. Twenty (61%) children presented with upper urinary tract dilation on prenatal ultrasound. In other patients, the diagnosis was made following work-up for urinary tract infection (12%), abdominal pain (3%), enuresis (3%), vomiting (6%), multiple congenital anomalies (3%) and coincidentally (12%). At diagnosis 8 (22%) renal units were demonstrated to be type I, 22 (61%) type II and 6 (17%) type III megaureter. Nine (27%) patients have variable urinary tract anomalies in contralateral kidneys. Twelve (36%) patients had urinary tract infection and three (9%) patients developed urolithiasis during follow-up. Megaureters showed spontaneous regression in 13 (39%) and persisted in 15 (46%) patients. Five (15%) patients with recurrent urinary tract infections underwent primary ureteric reimplantation. Renal scar and low differential function were displayed in two renal units. 

Conclusions:

Almost half of the NONR megaureters resolve spontaneously. The most frequent complication of NONR megaureter was urinary tract infection. On the other hand, the rate of renal scar and decreased renal function was low.