Editorial: Management of Primary Obstructive Megaureter.

Abstract

Primary obstructive megaureter (POM) represents one of the most challenging dilemmas in pediatric urology today. Antenatal and postnatal ultrasonography has significantly altered the detection of POM in children; not only being useful for the diagnosis, but also for the follow-up term. Thus, monitoring of these patients will continue for many years. Its assessment remains essential for the pediatric urologist. Diuretic renography with radiotracers has been used successfully to diagnose obstruction in patients with hydronephrosis. However, in many cases we may obtain inconclusive results. MRI is not a well-established test in infants, as it requires general anesthesia. The combination of clinical and radiological findings may presumably be the most effective diagnostic method nowadays. It is well-known that the majority of the POMs may be managed conservatively (spontaneous remission rates of up to 85%), but the indications for surgical intervention are less well-defined remaining controversial. Many authors believe that the large number of complications of ureteral reimplantation in infants with POM should be translated into a decrease in the indications for surgical treatment.