Optimization of diagnostic and therapeutic tactics for primary megaureter in children

Authors

DOI:

https://doi.org/10.14739/2310-1210.2026.4.353221

Keywords:

megaureter, diagnosis, treatment, children

Abstract

Congenital malformations of the urinary tract remain a relevant problem in pediatric surgery and urology. The optimal approach to diagnosis and treatment of patients of different ages with primary megaureter remains debated.

Aim. To analyze and compare the outcomes of endoscopic intervention and cutaneous ureterostomy in the diagnosis and treatment of primary megaureter in children of different ages.

Materials and methods. A total of 81 children aged 1 month to 15 years with primary megaureter were included. All children were allocated to two groups: Group I (n = 45, 55.5 %) underwent endoscopic intervention, and Group II (n = 36, 44.5 %) underwent decompressive ureterocutaneostomy.

Results. Children under 3 years of age significantly predominated in both groups: 57.7 % of Group I patients were aged <3 years vs. 42.3 % aged ≥3 years; in Group II, 61.1 % vs. 38.9 % (p < 0.05). In the obstructive variant of primary megaureter, positive upper urinary tract dynamics were recorded in 78.9 % of Group I cases compared to 61.5 % in Group II. In the reflux variant, improvement was observed in 41.2 % of Group I patients versus 29.4 % of Group II. Lower response rates in both treatment groups were associated with a greater degree of ureteral wall dysplasia, whereas endoscopic reconstructive surgery may create a valve-like mechanism that can concurrently impair urodynamics. We attribute this limitation partly to the use of minimally invasive corrective techniques in very young patients.

Conclusions. Endoscopic intervention was associated with significantly greater improvement in upper urinary tract dilatation compared to cutaneous ureterostomy, achieving positive outcomes in 78.9 % of obstructive and 41.2 % of reflux primary megaureter cases. Treatment of primary megaureter in children requires an individualized surgical strategy based on defect type, degree of upper urinary tract dilatation, prenatal history, and urinary tract infection status.

Author Biographies

O. V. Spakhi, Zaporizhzhia State Medical and Pharmaceutical University

MD, PhD, DSc, Professor of the Department of Pediatric Surgery

O. P. Pakholchuk, Zaporizhzhia State Medical and Pharmaceutical University

MD, PhD, Assistant at the Department of Pediatric Surgery

O. D. Kokorkin, Zaporizhzhia State Medical and Pharmaceutical University

MD, PhD, Associate Professor of the Department of Pediatric Surgery

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Published

2026-07-08

How to Cite

1.
Spakhi OV, Pakholchuk OP, Kokorkin OD. Optimization of diagnostic and therapeutic tactics for primary megaureter in children. Zaporozhye Medical Journal [Internet]. 2026Jul.8 [cited 2026Jul.13];28(4):329-33. Available from: https://zmj.zsmu.edu.ua/article/view/353221

Issue

Vol. 28 No. 4 (2026)

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Original research

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Copyright (c) 2026 O. V. Spakhi, O. P. Pakholchuk, O. D. Kokorkin

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