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Open Access 05-03-2024 | Vesicorenal Reflux | REVIEW

Primary non-refluxing megaureter: Natural history, follow-up and treatment

Authors: Giulio Rivetti, Pierluigi Marzuillo, Stefano Guarino, Anna Di Sessa, Angela La Manna, Anthony A. Caldamone, Alfonso Papparella, Carmine Noviello

Published in: European Journal of Pediatrics | Issue 5/2024

Abstract

Primary non-refluxing megaureter (PMU) is a congenital dilation of the ureter which is not related to vesicoureteral reflux, duplicated collecting systems, ureterocele, ectopic ureter, or posterior urethral valves and accounts for 5 to 10% of all prenatal hydronephrosis (HN) cases. The etiology is a dysfunction or stenosis of the distal ureter. Most often PMU remains asymptomatic with spontaneous resolution allowing for non-operative management. Nevertheless, in selective cases such as the development of febrile urinary tract infections, worsening of the ureteral dilatation, or reduction in relative renal function, surgery should be considered.

Conclusion: Ureteral replantation with excision of the dysfunctional ureteral segment and often ureteral tapering is the gold-standard procedure for PMU, although endoscopic treatment has been shown to have a fair success rate in many studies. In this review, we discuss the natural history, follow-up, and treatment of PMU.

What is Known:

• PMU is the result of an atonic or stenotic segment of the distal ureter, resulting in congenital dilation of the ureter, and is frequently diagnosed on routine antenatal ultrasound.

What is New:

• Most often, PMU remains asymptomatic and clinically stable, allowing for non-operative management.

• Nevertheless, since symptoms can appear even after years of observation, long-term ultrasound follow-up is recommended, even up to young adulthood, if hydroureteronephrosis persists.

• Ureteral replantation is the gold standard in case surgery is needed. In selected cases, however, HPBD could be a reasonable alternative.

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Title: Primary non-refluxing megaureter: Natural history, follow-up and treatment
Authors: Giulio Rivetti
Pierluigi Marzuillo
Stefano Guarino
Anna Di Sessa
Angela La Manna
Anthony A. Caldamone
Alfonso Papparella
Carmine Noviello
Publication date: 05-03-2024
Publisher: Springer Berlin Heidelberg
Keywords: Vesicorenal Reflux
Urinary Tract Infection
Antibiotic
Urethral Valve
Published in: European Journal of Pediatrics / Issue 5/2024
Print ISSN: 0340-6199
Electronic ISSN: 1432-1076
DOI: https://doi.org/10.1007/s00431-024-05494-7

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Primary non-refluxing megaureter: Natural history, follow-up and treatment

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

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