PRIMARY MEGAURETER TREATMENT

Primary obstructive megaureter (POM) without vesicoureteral reflux has classically been managed by open surgery with ureteral reimplantation. We present seven patients with POM who were treated endoscopically with balloon dilatation of the distal ureter.This is a prospective study of 87 patients with diagnosis of primary megaurether admitted to the pediatric surgical department of the University Hospital Center “Mother Teresa” in Tirana, Albania over the period 2000-2010. The postnatal diagnosis was also achieved by ultrasonography, along with a diuretic isotopic renogram with MAG-3, intravenous urography, and filling cystography. The age at surgery was 1 to 3 years. The mean follow-up of the patients is 36 months. Their clinical progress was highly satisfactory. 16 (18.4%) of the 87 patients underwent surgical intervention while 71 (81.6%) had a conservative treatment. After a follow-up period of 36 sia months 40 out of 71 children that had a conservative treatment remained stable while 31 of them improved. The decision regarding surgical repair of a megaureter in infants requires a complex balancing act by the pediatric urologist.