The utilization of stents in the management of primary obstructive megaureters requiring intervention before 1 year of age

作者：Farrugia Marie Klaire^*; Steinbrecher Henrik A; Malone Padraig S

来源：Journal of Pediatric Urology, 2011, 7(2): 198-202.

DOI：10.1016/j.jpurol.2010.04.015

• Primary megaureter
• Vesicoureteric junction
• Obstruction
• Stent
• Infant
• Antenatal hydronephrosis

Objective: To analyse the long-term outcome of 16 infants with primary obstructive megaureter managed by (endoscopic or open) stenting over a 10-year period.
Methods: A retrospective case-note and imaging review was performed between 1997 and 2007. Data are presented as medians (range) and were compared using the Mann-Whitney test.
Results: Sixteen infants with19 obstructed megaureters were stented at a median age of 24 weeks, for a median of 6 months. One-third of stents were inserted endoscopically. Complications (stent migration, stone formation or infection) occurred in 31.6%. One infant was excluded due to a co-existent pelviureteric junction obstruction. Drainage improved in 10 ureters (56%) following stent removal. Of the remaining renal units, 6 were reimplanted, and 2 underwent a nephrectomy due to deterioration in renal function following stent removal. Resolution of the vesicoureteric junction obstruction occurred in 4 of 6 infants following endoscopic stent insertion, and in 6 of 12 infants following open stent insertion (P = 0.60). There was no difference in the length of time that ureters were stented in the resolved (7.5 (6-15) months) versus the reimplanted (6.0 (1-18) months) group (P = 0.13).
Conclusions: Of obstructive megaureters managed by stenting for a median of 6 months, 56% did not require further surgery. However, morbidity occurred in one third of patients, and function deteriorated after removal of stent in two patients who later required a nephrectomy.

• 出版日期2011-4