Primary obstructed megaureter.

The clinical presentation and management of 57 primary obstructed megaureters in 46 patients, 35 of whom were children, are reported. Indications for operation include pain, infection, progressive pyelo-ureteric dilatation and reduction in the glomerular filtration rate. We have found that affected children cannot be managed successfully without operation. Conservative treatment may be employed effectively in adults in whom the condition is often stable and complications are less frequent. The preferred surgical technique is ureteric narrowing with reimplantation to the bladder by the Politano-Leadbetter method. The results of surgery are less satisfactory in adults than in children. This may be related to the reduced quantity of elastic tissue in the ureteric wall in adult cases.