Frohneberg D, Walz P H, Hohenfellner R
Eur Urol. 1983;9(6):321-8. doi: 10.1159/000474115.
The terminology of megaureters, their histological findings and etiology vary greatly in the literature. Primary obstructed megaureters must be clearly differentiated from megaureters caused by infravesical obstruction. The characterization and therapeutical consequences of the two types also differ. In a retrospective study, 43 adult patients with 54 primary obstructed megaureters (male:female = 30:13) were studied. This diagnosis excluded infravesical obstruction, reflux and neurogenic disorders. The main symptoms were flank pain, infection and hematuria. An operation was performed in 25 patients; 29 were treated conservatively. The criteria for surgery are discussed in relation to symptoms, functional reserves of the kidney, transportation capacity of the upper urinary tract, and histological changes of the narrow segment of the ureter. Operative treatment should be limited to well-defined complications, such as deterioration of kidney function or recurrent infection, to avoid its discredit as merely a cosmetic procedure.
巨输尿管的术语、组织学表现及病因在文献中差异很大。原发性梗阻性巨输尿管必须与膀胱下梗阻所致的巨输尿管明确区分。这两种类型的特征及治疗结果也有所不同。在一项回顾性研究中，对43例成年患者的54条原发性梗阻性巨输尿管（男∶女 = 30∶13）进行了研究。该诊断排除了膀胱下梗阻、反流及神经源性疾病。主要症状为胁腹痛、感染及血尿。25例患者接受了手术治疗；29例接受了保守治疗。结合症状、肾脏功能储备、上尿路输送能力及输尿管狭窄段的组织学变化，对手术标准进行了讨论。手术治疗应仅限于明确的并发症，如肾功能恶化或反复感染，以免仅被视为一种美容手术而受到质疑。
