Changing concepts in management of primary obstructive megaureter

Journal Article · Tue Aug 01 04:00:00 EDT 1989 · J. Urol.; (United States)

OSTI ID:5819572

Keating, M A; Escala, J; Snyder, III, H M; Heyman, S; Duckett, J W

The management of neonatal urinary tract dilatations represents one of the most challenging dilemmas in pediatric urology today. We have been confronted with 44 renal units in 35 neonates diagnosed as having primary obstructive megaureter during the last 6 years. Of these units 23 in 17 infants were diagnosed antenatally and 20 (87 per cent) have been managed without surgical intervention. Notably, 16 renal units were graded as moderate to severe megaureters by an excretory urogram. The decision to manage conservatively was based on the initial extraction of the /sup 99m/diethylenetriaminepentaacetic acid renal scan (the extraction factor). This estimate of absolute renal function has been used to differentiate dilatations with obstructive implications for the renal parenchyma from those without. Significantly, expectant treatment has resulted in improvement of dilatation on sequential excretory urograms in 15 megaureters and none has shown a deterioration of function by renal scan. Similar diagnostic criterion also has resulted in conservative management for 12 of 21 additional neonatal megaureters seen during this period with symptoms or they were discovered serendipitously. Only 2 of these 12 megaureters required surgical correction. The neonatal primary megaureter appears in many cases to represent a different entity than those that commonly presented before the advent of antenatal and perinatal diagnosis.

• Research Organization: Children's Hospital of Philadelphia, PA (USA)
• OSTI ID: 5819572
• Journal Information: J. Urol.; (United States), Journal Name: J. Urol.; (United States) Vol. 142:2 Pt 2; ISSN JOURA
• Country of Publication: United States
• Language: English

Related Subjects

550601* -- Medicine-- Unsealed Radionuclides in Diagnostics
62 RADIOLOGY AND NUCLEAR MEDICINE
AGE GROUPS
AMINO ACIDS
BETA DECAY RADIOISOTOPES
BETA-MINUS DECAY RADIOISOTOPES
BODY
CARBOXYLIC ACIDS
CHELATING AGENTS
CHILDREN
COUNTING TECHNIQUES
DIAGNOSIS
DISEASES
DRUGS
DTPA
HOURS LIVING RADIOISOTOPES
INFANTS
INTERMEDIATE MASS NUCLEI
ISOMERIC NUCLEI
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
KIDNEYS
NUCLEI
ODD-EVEN NUCLEI
ORGANIC ACIDS
ORGANIC COMPOUNDS
ORGANS
RADIOISOTOPE SCANNING
RADIOISOTOPES
RADIOPROTECTIVE SUBSTANCES
TECHNETIUM 99
TECHNETIUM ISOTOPES
UROGENITAL SYSTEM DISEASES
YEARS LIVING RADIOISOTOPES