PubMed1993
Due to the widespread use of obstetrical ultrasonography with concomitant fetal screening, congenital uropathies are usually diagnosed in asymptomatic neonates. The main issue is to distinguish those cases of dilatation which are clearly obstructive and need surgical treatment from those which are within the normal anatomical range. Out of 47 patients with primary megaureter, 23 were nonobstructive, these are the aim of our study. There were 16 males and 7 females; 13 were located on the left side, 7 on the right side and 3 were bilateral, adding up to 26 reno-ureteral units. Prenatal diagnosis was performed in 16 cases, the eldest patient diagnosed was nine. All infants were evaluated with ultrasonography, voiding cystourethrography, excretory urography and diuresis renography. The latter has been the most important test inducing us to adopt a conservative attitude. Differential renal function was more than 40% in 24 units and in 2 was more than 35%. Diuretic renograms were type IIIa (Dilated non obstructed) in 19 cases and IIIb (Dilated partially obstructed) in 7. There were 2 cases with vesicoureteral reflux in the contralateral system. We have performed ultrasonography and diuresis renography during the follow-up. There were 8 cases with type I (Normal) renograms and 17 cases with type IIIa. Only one patient developed an obstruction and was operated on. In every case differential renal function did not deteriorate. In 9 cases urography was performed in order to see the anatomical changes. They have remained asymptomatic during the follow-up except for two cases which presented urinary tract infection. BUN, creatinine and other biochemical figures remained within normal ranges.(ABSTRACT TRUNCATED AT 250 WORDS)