[Surgical treatment of ureterectasia].

Abstract

Ureterectasia can be congenital (mega-ureter) or acquired (hydro-ureter). Mega-ureters can be of reflux and non-reflux (obstructive) type. The essence of primary non-reflux mega-ureters is the presence of a prevesical adynamic segment which causes functional obstruction. The musculature of this segment is abnormal in both function and structure. A surgical solution of the malformation is recommended mainly in children and young adults. In 10 years, 17 patients were subjected to 22 operations. After removal of the obstructive segment and straightening of the ureter, it was implanted into the vesicle through an intravesical tunnel. With the exception of two cases where nephrectomy had to be done and a case with persisting reflux, the other operations were successful. Narrowing of the ureter was not done. Ureteral neo-implantation is preferred to Boari's operation. Isolated pelvis ureters are operated only in the case of complications.