Result of Endoureterotomy in the Management of Primary Obstructive Megaureter in the First Year of Life: Preliminary Report

Shirazi, Mehdi; Natami, Mohammad; Hekmati, Pooya; Farsiani, Mohamadreza

doi:10.1089/end.2013.0098

Cited by 7 publications

(3 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…31 Endoureterotomy has a high success rate, even for patients under 1 year of age, avoiding complications associated with open surgery. 32 A ureter with a diameter of more than 15-25 mm is one of the contraindications for endoscopic balloon dilation. In these cases, the authors found, according to existing information in the literature, that ureterovesical reimplantation with ureteral remodeling provides superior results on peristaltic improvement and postoperative evolution.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous resolution and the role of endoscopic surgery in the treatment of primary obstructive megaureter: a review of the literature

Isac,

Danila,

Ionescu

2023

Pediatr Med Chir

View full text Add to dashboard Cite

The megaureter accounts for almost a quarter of all urinary tract dilations diagnosed in utero and is the second leading cause of hydronephrosis in newborns, following pyeloureteral junction obstruction. The current standard treatment for progressive or persistent, symptomatic primary obstructive megaureter is ureteral anti-reflux reimplantation, which can be associated with ureteral remodeling or plication. Due to the associated morbidity, postoperative recovery challenges, and the complications that may arise from the open surgical approach, there has been a natural inclination towards validating new minimally invasive techniques. This study reviews the literature, extracting data from three major international databases, from 1998 to 2022. Out of 1172 initially identified articles, only 52 were deemed eligible, analyzing 1764 patients and 1981 renal units. Results show that 65% of cases required surgical intervention, with minimally invasive techniques constituting 56% of these procedures. High-pressure endoscopic balloon dilation was the preferred endourologic technique. The degree of ureterohydronephrosis is considered one of the factors indicating the need for surgery. There is an inverse relationship between the diameter of the ureter and the likelihood of spontaneous resolution. Conditions such as renal hypoplasia, renal dysplasia, or ectopic ureteral insertion strongly indicate a poor prognosis. Endoscopic surgical techniques for treating primary obstructive megaureter can be definitive, firstline treatment options. In selected cases, they might be at least as effective and safe as the open approach, but with advantages like quicker recovery, fewer complications, shorter hospital stays, and reduced costs.

show abstract

Section: Discussionmentioning

confidence: 99%

Spontaneous resolution and the role of endoscopic surgery in the treatment of primary obstructive megaureter: a review of the literature

Isac,

Danila,

Ionescu

2023

Pediatr Med Chir

View full text Add to dashboard Cite

show abstract

“…Follow-up of 1 to 4 years achieved free drainage with a marked reduction in proximal stasis and freedom from recurrent infection and pain (51). Endoureterotomy using pure cutting current was also applied in the pediatric population, achieving satisfactory success rates of approximately 90% with a low incidence of complications (52,53). Electrocauter y incisions of fer precise control of t he incision widt h and lengt h and immediate local hemostasis (52).…”

Section: Endoureterotomymentioning

confidence: 99%

“…De s pit e t he c ut t i ng mo d a l it y, endoureterotomy appears to be safer, easier, and less invasive than open surgical management. It prevents damage to the vasculature near the distal ureter and decreases the rate of postoperative morbidity and costs compared with ureteral reimplantation, although its applicability needs to be validated (53).…”

Section: Endoureterotomymentioning

confidence: 99%

Minimally invasive ureteral reimplantation or endoscopic management for primary obstructive megaureter: a narrative review of technical modifications and clinical outcomes

Yang

et al. 2022

Transl Androl Urol

View full text Add to dashboard Cite

Background and Objective: Primary obstructive megaureter (POM) has various courses in different age populations. Although open ureteral reimplantation (OUR) remains the standard treatment for symptomatic POM, it is highly invasive with potential complications. In recent years, minimally invasive ureteral reimplantation (MIUR), including laparoscopic ureteral reimplantation (LUR) and roboticassisted laparoscopic ureteral reimplantation (RALUR), and endoscopic management, such as double-J stent insertion, endoureterotomy and endoscopic balloon dilatation (EBD), have been utilized for POM in selected patients. However, few comparable studies between MIUR and endoscopic management have been published to date, and it remains unclear which surgical management is the optimal choice for POM in different age groups. This review provides a comprehensive perspective on technical development and clinical outcomes of MIUR and endoscopic management for POM in pediatric and adult populations. Methods:The PubMed and Web of Science databases were used to comprehensively search English language articles related to MIUR and endoscopic management for POM in pediatric and adult populations up to March 2022. The technical modifications and the relevant clinical outcomes were reviewed. Key Content and Findings: MIUR with various technical modifications related to intracorporealsuturing and ureteroneocystostomy with anti-reflux techniques appears to be as safe and effective for POM in different age groups as the open procedure. Double-J stent insertion should be regarded as a temporary option for infants by achieving internal urinary drainage, as it may present limited success rates and various complications. Endoureterotomy using pure cutting current or laser appears to be a safer, easier, and less invasive alternative to open surgical management. While EBD has emerged as a definite treatment for POM in the pediatric population, it is debatable whether EBD can substitute for MIUR in adult patients. Conclusions:The safety and feasibility of MIUR and endoscopic management in patients from all age groups still need further investigation.

show abstract

Advancements in Surgical Management of Megaureters

Boswell

2024

Curr Urol Rep

View full text Add to dashboard Cite

Purpose of Review To review and describe the recent evolution of surgery for the various types of pediatric megaureter. Recent Findings Megaureter management first relies on determining the underlying cause, whether by obstruction, reflux, or a combination, and then setting appropriate surgical indications because many cases do not require surgery as shown by observation studies. Endoscopic balloon dilation has been on the rise as a major treatment option for obstructive megaureter, while refluxing megaureters can also be treated by laparoscopic and robotic techniques, whether extravesically or transvesicoscopically. During ureteral reimplantation, tapering is sometimes necessary to address the enlarged ureter, but there are also considerations for not tapering or for tapering alternatives. Summary Endoscopic and minimally invasive surgeries for megaureter have been the predominant focus of recent megaureter literature. These techniques still need collaborative prospective studies to better define which surgeries are best for patients needing megaureter interventions.

show abstract

Result of Endoureterotomy in the Management of Primary Obstructive Megaureter in the First Year of Life: Preliminary Report

Abstract: According to the results of our study, endoureterotomy may be an alternative in management of POMU. Of course, further studies with longer follow-up periods are needed to confirm the applicability of this method in patients younger than 1 year.

Cited by 7 publications

References 33 publications

Spontaneous resolution and the role of endoscopic surgery in the treatment of primary obstructive megaureter: a review of the literature

Spontaneous resolution and the role of endoscopic surgery in the treatment of primary obstructive megaureter: a review of the literature

Minimally invasive ureteral reimplantation or endoscopic management for primary obstructive megaureter: a narrative review of technical modifications and clinical outcomes

Advancements in Surgical Management of Megaureters

Contact Info

Product

Resources

About