[Diagnostic management of primary megaureter : Voiding cystourethrography obligatory, scintigraphy useful?]

[Diagnostic management of primary megaureter : Voiding cystourethrography obligatory, scintigraphy useful?]
Urologe A. 2020 Feb 06;:
Authors: Younsi N
Abstract
A primary, congenital megaureter means a dilatation of the ureter with a ureteric diameter ≥7 mm due to a structural or functional obstruction of the ureterovesical junction and represents the second most likely cause of neonatal hydronephrosis. Conservative management is the primary treatment option for many patients due to a high spontaneous remission rate of up to 85%. Concerning diagnostic management, meticulous and repeat postnatal evaluation by ultrasound is mandatory to identify patients who are at risk of renal deterioration. Routine voiding cystourethrography or contrast-enhanced voiding urosonography is currently recommended for all patients to detect vesicoureterorenal reflux and other concomitant pathologies. The relevance of the additional information provided by this examination must be critically questioned considering the lack of clinical consequences. Moreover, the question arises as to whether these examinations should be prolonged until clinical symptoms occur. Nevertheless, a subvesical obstruction should still be ruled out for male patients with a bilateral megaureter. The same critical discussion is necessary for the routine use of diuretic renography in patients with primary megaureter. In principal, this examination is used to determine the g...

Source: Der Urologe. Ausg. A - February 5, 2020 Category: Urology & Nephrology Authors: Younsi N Tags: Urologe A Source Type: research