Our Summary

“Megaureter” is a term used to describe an unusually large ureter, which is the tube that carries urine from the kidneys to the bladder. In some cases, these megaureters can go back to normal on their own during early childhood. However, the most severely enlarged type, known as type III megaureters, don’t get better without medical intervention.

For these cases, the authors recommend a two-step surgical process. First, a temporary bypass is created to alleviate any blockage. Then, once the child is around one year old and their bladder function has matured more, the actual corrective surgery is performed. This involves closing the temporary bypass.

Ultrasound imaging is used to monitor the situation until the corrective surgery is carried out. Additional tests, such as a voiding cystourethrogram (a type of X-ray of the bladder) and MAG-3 diuretic renography (a nuclear medicine scan that evaluates kidney function), can also be used before the bypass is closed to ensure there are no other issues.

FAQs

  1. What is a megaureter and how can it be treated?
  2. What does the two-step surgical process for treating type III megaureters involve?
  3. What tests and imaging techniques are used to monitor a child with a type III megaureter before and after surgery?

Doctor’s Tip

It’s important to follow up with your doctor regularly and adhere to their recommendations for monitoring and treatment of your ureterostomy. Staying informed and proactive about your condition can help ensure the best possible outcome.

Suitable For

Overall, patients who are typically recommended ureterostomy are those with severe type III megaureters that do not improve on their own and require surgical intervention to correct the condition. These patients are usually young children who have not responded to other treatment options and are experiencing complications such as urinary tract infections or kidney damage. Monitoring and additional testing are often necessary to ensure the success of the surgery and the overall health of the patient.

Timeline

Before ureterostomy:

  • Patient is diagnosed with a type III megaureter, a severely enlarged ureter that requires medical intervention.
  • Temporary bypass surgery is performed to alleviate blockage and prevent kidney damage.
  • Patient undergoes ultrasound imaging and other tests to monitor the condition and evaluate kidney function.
  • Patient may need to wait until around one year old for the bladder function to mature before the corrective surgery can be performed.

After ureterostomy:

  • Corrective surgery is performed to close the temporary bypass and restore normal urine flow from the kidney to the bladder.
  • Patient continues to be monitored with follow-up appointments and imaging to ensure the ureterostomy is successful and there are no complications.
  • With proper care and monitoring, the patient can lead a normal and healthy life with a functioning urinary system.

What to Ask Your Doctor

  1. What is a ureterostomy and why is it necessary for my condition?
  2. What are the risks and potential complications associated with the surgical procedure?
  3. How long will I need to stay in the hospital after the surgery?
  4. What is the expected recovery time and when can I resume normal activities?
  5. Will I need to make any lifestyle changes or follow any specific post-operative care instructions?
  6. What follow-up appointments or tests will be necessary to monitor my condition after the surgery?
  7. Are there any restrictions on diet or medication that I should be aware of?
  8. What are the long-term implications of having a ureterostomy, if any?
  9. Are there any alternative treatment options available for my condition?
  10. How successful is this surgical procedure in resolving megaureter in children?

Reference

Authors: Rübben I, Vester U. Journal: Aktuelle Urol. 2020 Apr;51(2):132-136. doi: 10.1055/a-0966-4663. Epub 2020 Jan 22. PMID: 31968361