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Abstract：
Primary non-refluxing megaureter (PMU) is a congenital dilation of the ureter which is not related to vesicoureteral reflux, duplicated collecting systems, ureterocele, ectopic ureter, or posterior urethral valves and accounts for 5 to 10% of all prenatal hydronephrosis (HN) cases. The etiology is a dysfunction or stenosis of the distal ureter. Most often PMU remains asymptomatic with spontaneous resolution allowing for non-operative management. Nevertheless, in selective cases such as the development of febrile urinary tract infections, worsening of the ureteral dilatation, or reduction in relative renal function, surgery should be considered.
CONCLUSIONS: Ureteral replantation with excision of the dysfunctional ureteral segment and often ureteral tapering is the gold-standard procedure for PMU, although endoscopic treatment has been shown to have a fair success rate in many studies. In this review, we discuss the natural history, follow-up, and treatment of PMU.
BACKGROUND: • PMU is the result of an atonic or stenotic segment of the distal ureter, resulting in congenital dilation of the ureter, and is frequently diagnosed on routine antenatal ultrasound.
BACKGROUND: • Most often, PMU remains asymptomatic and clinically stable, allowing for non-operative management. • Nevertheless, since symptoms can appear even after years of observation, long-term ultrasound follow-up is recommended, even up to young adulthood, if hydroureteronephrosis persists. • Ureteral replantation is the gold standard in case surgery is needed. In selected cases, however, HPBD could be a reasonable alternative.
CONCLUSIONS: Ureteral replantation with excision of the dysfunctional ureteral segment and often ureteral tapering is the gold-standard procedure for PMU, although endoscopic treatment has been shown to have a fair success rate in many studies. In this review, we discuss the natural history, follow-up, and treatment of PMU.
BACKGROUND: • PMU is the result of an atonic or stenotic segment of the distal ureter, resulting in congenital dilation of the ureter, and is frequently diagnosed on routine antenatal ultrasound.
BACKGROUND: • Most often, PMU remains asymptomatic and clinically stable, allowing for non-operative management. • Nevertheless, since symptoms can appear even after years of observation, long-term ultrasound follow-up is recommended, even up to young adulthood, if hydroureteronephrosis persists. • Ureteral replantation is the gold standard in case surgery is needed. In selected cases, however, HPBD could be a reasonable alternative.
摘要：
原发性非反流性巨输尿管（PMU）是先天性输尿管扩张，与膀胱输尿管反流无关，重复的收集系统，输尿管囊肿,输尿管异位,或后尿道瓣膜，占所有产前肾积水（HN）病例的5％至10％。病因是输尿管远端功能障碍或狭窄。大多数情况下，PMU保持无症状，自发消退，允许非手术治疗。然而，在选择性病例中，如发热性尿路感染的发展，输尿管扩张的恶化，或相对肾功能下降，应该考虑手术。
结论：切除功能失调的输尿管段并经常进行输尿管变细的输尿管再植是PMU的金标准程序，尽管在许多研究中已经证明内镜治疗具有相当的成功率。在这次审查中,我们讨论自然历史，后续行动,和PMU的治疗。
背景：•PMU是输尿管远端无张力或狭窄段的结果，导致先天性输尿管扩张，并且经常在常规产前超声检查中被诊断。
背景：•大多数情况下，PMU保持无症状和临床稳定，允许非手术管理。•尽管如此，因为即使经过多年的观察，症状也会出现，建议长期超声随访，甚至到了年轻的成年，如果输尿管肾积水持续存在。•输尿管再植是需要手术的金标准。在某些情况下，然而,HPBD可能是一个合理的选择。
结论：切除功能失调的输尿管段并经常进行输尿管变细的输尿管再植是PMU的金标准程序，尽管在许多研究中已经证明内镜治疗具有相当的成功率。在这次审查中,我们讨论自然历史，后续行动,和PMU的治疗。
背景：•PMU是输尿管远端无张力或狭窄段的结果，导致先天性输尿管扩张，并且经常在常规产前超声检查中被诊断。
背景：•大多数情况下，PMU保持无症状和临床稳定，允许非手术管理。•尽管如此，因为即使经过多年的观察，症状也会出现，建议长期超声随访，甚至到了年轻的成年，如果输尿管肾积水持续存在。•输尿管再植是需要手术的金标准。在某些情况下，然而,HPBD可能是一个合理的选择。
