Primary obstructive megaureter in children.

Sixty-five cases of primary obstructive megaureter were retrospectively evaluated. The clinicoradiologic features of the abnormality are characteristic; however, a complete urologic workup is necessary to exclude the more common causes of ureteral dilatation. Treatment must be planned according to status of renal and ureteral functions. Surgical excision of the obstructive segment, reduction of ureteral caliber when indicated, and reimplantation achieved the best results in this series. A brief period of nephrostomy drainage prior to surgical remodeling of the lower ureter can be useful in selected cases. Conservative treatment of children with relatively few symptoms and slight ureteral dilatation is worthwhile.