Abstract Objectives Clinical and radiological criteria for predicting surgical approach or spontaneous resolution have been evaluated mainly in primary non‐refluxing megaureters detected prenatally. We aimed to analyze these criteria in a retrospectively collected cohort of children with either prenatal or postnatal diagnosis of non‐obstructive non‐refluxing (NONR) megaureter. Methods Hospital files of the children with NONR megaureter were evaluated retrospectively for age at diagnosis, presenting complaint, follow‐up period, accompanying urologic abnormalities, complications (renal scar and urinary tract infection), and final status. Results There were 27 NONR megaureters in 25 patients (male/female: 19/6; prenatal/postnatal: 18/7). Two prenatal cases had bilateral involvement. Spontaneous resolution rate in renal units was lower in postnatal cases than in prenatal cases (2 out of 7 vs. 15 out of 20, OR 7.5). Spontaneous resolution rate was also higher when ureteral diameter was 10 mm (OR 19.2). Surgical intervention rate was higher in the presence of ureteral diameter ≥14 versus <14 mm (OR 22.0). Renal units that underwent surgical treatment showed higher rates of febrile urinary tract infections, renal scarring, and reduced renal function on 99m Tc‐MAG3 scintigraphy compared to those without surgical intervention. Conclusions Initial management of asymptomatic non‐refluxing megaureters should be observational monitoring. Majority of them resolve spontaneously if ureteral diameter is <11 mm with renal pelvis anteroposterior diameter ≤10 mm. However, children with ureteral diameter ≥14 mm are prone to develop febrile urinary tract infection, renal scar, and decreased renal function requiring surgical intervention.
Yıldız et al. (Thu,) studied this question.
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