megaureter in children : a retrospective study of 11 cases from the mother and child EHS of Tlemcen

Abstract

Introduction: Megaureter (MU) is defined as a congenital dilatation of the ureter > or = 7 mm, it can be associated with vesico ureteral reflux. It is often diagnosed after recurrent urinary tract infection (UTI), but currently, it can be diagnosed since the 3rd trimester of pregnancy thanks to antenatal ultrasound. Material and methods: Our retrospective study was managed in the Pediatric Surgery service at the mother and child EHS of Tlemcen about 11 children and 11 cases of megaurter(MU) between January 2021 and July 2022. Results: In our series we noted a male predominance (72,72% of cases), the mean age of diagnosis was about 5 and ½ years, and three cases was antenatally diagnosed. Eight out of 11 cases were unilaterale and 5 were right sided. Clinical examination of our patients was poor.Six units were refluxing confirmed with retrograde cystography. IVU and scintgraphy were used to confirm the obstructed character of MU. The obstructed non refluxing MU was confirmed in more than 36% of cases. Surgery was performed for 8 patients. The surgical treatment consisting to the resection of the zone narrows and antireflux re-imlpantation with remodeling of the ureter. We used Cohen procedure in 36.36% of cases, modelling intervention using Kalicinski and Starr's technique procedure in 18.18% of cases and the nephrectomy procedure in 18.18% of cases. After surgery no patient presented a urinary tract infection and renal dilatation tended to regression or stabilization. Conclusion: The management of PMU is now well codified especially for patients diagnosed prenatally, and surgical treatment appears to have good results when it is indicated.