Özet:

Aim: Obstructive megaureter composes 10% of the prenatally diagnosed cases of hydronephrosis. During the recent 20 years, some changes have appeared in the follow-up and treatment of the cases with obstructive megaureter in conjunction to the increase in prenatally diagnosed cases. In this article, cases of obstructive megaureter operated in our clinic has been presented and results of treatment have been discussed on the basis of literature knowledge.Materials and methods: 22 cases operated for the diagnosis of obstructive megaureter between 2007 and 2011 were evaluated retrospectively by the hospital records. Increasing renal pelvis diameter, decreasing renal functions, recurrent urinary tract infection and flank pain were the parameters for indication of surgical intervention in these cases of obstructive megaureter.Results: Total of 22 cases (8 girls and 14 boys) with the mean age of 2.23± 2.42 years (age range: 1 month-8 years) were evaluated retrospectively. Obstruction was determined at the right ureter in 4 cases, at the left ureter in 17 cases, and bilateral in one case. Eleven cases were diagnosed during investigation for prenatally identified hydronephrosis. Early surgical intervention was performed in 3 cases with solitary kidney under the age of one. Ureterocutaneostomy was carried out for one case with urosepsis and definitive operation was conducted after one year of age. Ureteroneocystostomy was performed for 18 cases by reducing the diameter of the ureter, whereas 4 cases were followed up after a JJ catheter was placed. Discussion: Primary obstructive megaureter is a rare urinary system abnormalities. There is no consensus on the treatment of this disease, yet. Follow-up is controversial especially in cases recognized as antenatal hydronephrosis. Although these cases could be followed by endoscopically placing a JJ catheter; this has not been feasible in most of our cases. In such cases, a temporary ureterocutaneostomy can be performed when it is necessary. Furthermore, ureteroneocystostomy by reducing the diameter of the ureter has been a prefered option for cases over one year of age. Open surgery might be necessary especially in cases with solitary kidney at an early stage

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