ESPN 53rd Annual Meeting

ESPN 2021


 
CONSERVATIVE MANAGEMENT OF NON-REFLUXING NON-OBSTRUCTIVE MEGAURETER: A LONGITUDINAL OBSERVATIONAL STUDY
SEÇIL KEZER 1 CIHANGIR AKGÜN 1 ÖNDER YAVAŞCAN 1

1- İSTANBUL MEDIPOL UNIVERSITY, FACULTY OF MEDICINE, DEPARTMENT OF PEDIATRIC NEPHROLOGY
 
Introduction:

There is a lack of prospective studies that include a selected population of patients with non-refluxing non-obstructive megaureter (MU). We aimed to examine the 2-year follow-up results of non-refluxive non-obstructive MU patients who dont require surgery..

Material and methods:

 17[(22 kidney units (KU))MU cases who were followed up between 2018 and 2021 at Medipol University, Faculty of Medicine, Division of Pediatric Nephrology were included in the study. Group 1 was defined as improved or regressed KU according to hydronephrosis degrees and diameters. Group 2 was defined as worsened or remained stable KU. Cases were analyzed retrospectively ultrasonographic (US) findings, in terms of urinary tract infection (UTI) frequency, stone and growth (height and weight SDS scores) parameters.

 

Results:

13 (76.4%) of the 17 cases were diagnosed antenatally. 13 of cases were boys. 3 of the 17 cases were found on the right side, 5 were bilateral and 9 were found on the left side. We determined no statistically significant difference in terms of hydronephrosis severity, UTI frequency or initial and final growth scores between Group 1 and Group 2 (Table 1).

 

Table 1. Comparison of groups

 

Group 1

(regressed, improved)

Group 2

(worsened, stable)

 

  patient(n)

10

 

  Follow-up time(mean±SD, month)

22±13

16,3±7

 

  US(initial-final), median,mm

 

 

 

 AP diameter

10,6-6,6

14,9-18

 

 Proximal ureter

7,5-4

8,4-8

 

 Distal ureter

9,2-6

9,1-11

 

 Parenchymal thickness

4,7-9,3

4,5-7,8

 

 Kıdney Zscore

2,8-2

3,2-2,2

 

 Stone n

0

3

 

 Grade 1-2 echogenity n

2

1

 

   UTI n

3

2

 

  Growth initial-finalSDS (median)

 

 

 

 Weight  

0,37 /0,80

0,15 /0,15

 

 Height

0,35 /0,28

0,30 /0,15

 

    SD:Standard deviation, AP:Anteriorposterior , SDS: Standard deviation score.

 

Conclusions:

 Although US findings cause concern for the doctor and parents in MU cases without reflux and obstruction, we could be interpreted to these cases having a low risk of causing problems in terms of UTI, parenchymal damage and growth.