Primary obstructive megaureter in children; 10 years' experience from a tertiary care center
Introduction: Primary obstructive megaureter (POM) is a congenital dilatation of the ureter due to an adynamic segment of vesicoureteric junction obstruction. Surgical intervention is needed if nuclear scan shows obstructive curve. We analyzed our data and outcome of conservative and surgical treatm...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2022-01-01
|
| Series: | Urology Annals |
| Subjects: | |
| Online Access: | http://www.urologyannals.com/article.asp?issn=0974-7796;year=2022;volume=14;issue=3;spage=252;epage=258;aulast=Hamid |
| _version_ | 1811309514581868544 |
|---|---|
| author | Raashid Hamid Nisar A Bhat Ajaz A Baba Gowhar Nazir Mufti Khursheed A Sheikh Mohd Idrees Bashir |
| author_facet | Raashid Hamid Nisar A Bhat Ajaz A Baba Gowhar Nazir Mufti Khursheed A Sheikh Mohd Idrees Bashir |
| author_sort | Raashid Hamid |
| collection | DOAJ |
| description | Introduction: Primary obstructive megaureter (POM) is a congenital dilatation of the ureter due to an adynamic segment of vesicoureteric junction obstruction. Surgical intervention is needed if nuclear scan shows obstructive curve. We analyzed our data and outcome of conservative and surgical treatment in such cases at our tertiary care hospital.
Materials and Methods: We evaluated all cases of POMs during the study period. Investigations included ultrasonography (USG), voiding cystourethrogram, diethylene pentacetic acid (DTPA) scan, and dimercaptosuccinyle acid scan. In antenatal cases, any pelvic dilatation ≥12 mm after 6 weeks were subjected to reonography. Patients with anterior-posterior pelvic diameter (APPD) ≥12 mm had to undergo DTPA scan to look for DRF and drainage. Follow-up USG was done in all cases of mild-to-moderate hydroureteronephrosis, with APPD <12 at 3 months interval.
Results: A total of 270 megaureters were registered and treated during the study period (2008–2019). The total number of patients included was 50 (64 ureters). The mean age of presentation in these 30 children was 21.78 ± 18.1 months (range 1–72 months) and the mean weeks of gestation in antenatal cases at presentation as megaureter was 24 ± 7 weeks (range 13–37 weeks). The mean weight of babies was 2.72 ± 0.7 g. The duration of follow-up ranged from 16 to 1W12 months. The mean APPD on the affected side was 19.99 ± 10.3 mm (range 11–43 mm). The mean ureteric diameter was 1.67 ± 0.33 mm (range 0.78–2.66 cm). The mean split function of patients with POM was 34.88% ± 11.5% on the affected side. Twenty patients (40%) had spontaneous resolution over a mean time period of 24.1 ± 11.1 months. Thirty patients underwent surgical procedures. In three children, HTN was observed over a mean follow-up period of 3 years.
Conclusion: The babies with POM need a close follow-up. Surgery is indicated in prolonged t½/Tmax on renal scan, function <40% at the initial scan, or >5% split function deterioration in the subsequent renal scan. |
| first_indexed | 2024-04-13T09:43:13Z |
| format | Article |
| id | doaj.art-c78a792b6bf14cb996c5d577ecf9e96b |
| institution | Directory Open Access Journal |
| issn | 0974-7796 0974-7834 |
| language | English |
| last_indexed | 2024-04-13T09:43:13Z |
| publishDate | 2022-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Urology Annals |
| spelling | doaj.art-c78a792b6bf14cb996c5d577ecf9e96b2022-12-22T02:51:52ZengWolters Kluwer Medknow PublicationsUrology Annals0974-77960974-78342022-01-0114325225810.4103/UA.UA_77_20Primary obstructive megaureter in children; 10 years' experience from a tertiary care centerRaashid HamidNisar A BhatAjaz A BabaGowhar Nazir MuftiKhursheed A SheikhMohd Idrees BashirIntroduction: Primary obstructive megaureter (POM) is a congenital dilatation of the ureter due to an adynamic segment of vesicoureteric junction obstruction. Surgical intervention is needed if nuclear scan shows obstructive curve. We analyzed our data and outcome of conservative and surgical treatment in such cases at our tertiary care hospital. Materials and Methods: We evaluated all cases of POMs during the study period. Investigations included ultrasonography (USG), voiding cystourethrogram, diethylene pentacetic acid (DTPA) scan, and dimercaptosuccinyle acid scan. In antenatal cases, any pelvic dilatation ≥12 mm after 6 weeks were subjected to reonography. Patients with anterior-posterior pelvic diameter (APPD) ≥12 mm had to undergo DTPA scan to look for DRF and drainage. Follow-up USG was done in all cases of mild-to-moderate hydroureteronephrosis, with APPD <12 at 3 months interval. Results: A total of 270 megaureters were registered and treated during the study period (2008–2019). The total number of patients included was 50 (64 ureters). The mean age of presentation in these 30 children was 21.78 ± 18.1 months (range 1–72 months) and the mean weeks of gestation in antenatal cases at presentation as megaureter was 24 ± 7 weeks (range 13–37 weeks). The mean weight of babies was 2.72 ± 0.7 g. The duration of follow-up ranged from 16 to 1W12 months. The mean APPD on the affected side was 19.99 ± 10.3 mm (range 11–43 mm). The mean ureteric diameter was 1.67 ± 0.33 mm (range 0.78–2.66 cm). The mean split function of patients with POM was 34.88% ± 11.5% on the affected side. Twenty patients (40%) had spontaneous resolution over a mean time period of 24.1 ± 11.1 months. Thirty patients underwent surgical procedures. In three children, HTN was observed over a mean follow-up period of 3 years. Conclusion: The babies with POM need a close follow-up. Surgery is indicated in prolonged t½/Tmax on renal scan, function <40% at the initial scan, or >5% split function deterioration in the subsequent renal scan.http://www.urologyannals.com/article.asp?issn=0974-7796;year=2022;volume=14;issue=3;spage=252;epage=258;aulast=Hamidbritish association of psediatric urologistsdifferential renal functionglomerular filtration ratehydroureteronephrosisprimary obstructive megauretersultrasonographyvesicoureteric reflux |
| spellingShingle | Raashid Hamid Nisar A Bhat Ajaz A Baba Gowhar Nazir Mufti Khursheed A Sheikh Mohd Idrees Bashir Primary obstructive megaureter in children; 10 years' experience from a tertiary care center Urology Annals british association of psediatric urologists differential renal function glomerular filtration rate hydroureteronephrosis primary obstructive megaureters ultrasonography vesicoureteric reflux |
| title | Primary obstructive megaureter in children; 10 years' experience from a tertiary care center |
| title_full | Primary obstructive megaureter in children; 10 years' experience from a tertiary care center |
| title_fullStr | Primary obstructive megaureter in children; 10 years' experience from a tertiary care center |
| title_full_unstemmed | Primary obstructive megaureter in children; 10 years' experience from a tertiary care center |
| title_short | Primary obstructive megaureter in children; 10 years' experience from a tertiary care center |
| title_sort | primary obstructive megaureter in children 10 years experience from a tertiary care center |
| topic | british association of psediatric urologists differential renal function glomerular filtration rate hydroureteronephrosis primary obstructive megaureters ultrasonography vesicoureteric reflux |
| url | http://www.urologyannals.com/article.asp?issn=0974-7796;year=2022;volume=14;issue=3;spage=252;epage=258;aulast=Hamid |
| work_keys_str_mv | AT raashidhamid primaryobstructivemegaureterinchildren10yearsexperiencefromatertiarycarecenter AT nisarabhat primaryobstructivemegaureterinchildren10yearsexperiencefromatertiarycarecenter AT ajazababa primaryobstructivemegaureterinchildren10yearsexperiencefromatertiarycarecenter AT gowharnazirmufti primaryobstructivemegaureterinchildren10yearsexperiencefromatertiarycarecenter AT khursheedasheikh primaryobstructivemegaureterinchildren10yearsexperiencefromatertiarycarecenter AT mohdidreesbashir primaryobstructivemegaureterinchildren10yearsexperiencefromatertiarycarecenter |