This is a descriptive term used to denote a dilated ureter. The underlying reasons fo this dilatation can be an obstruction (beyond the dilatation or vesicoureteric reflux and in some cases both.
This finding can be detected on prenatal scans however the mild to moderately dilated ureter is difficult to detect on the prenatal ultrasound scans. The main stay of diagnosis is a renal tract ultrasound and an isotope scan to assess function in that and the opposite kidney.
The management consists of close follow up with ultrasound scans and isotope scans as necessary. Surgery is indicated in cases where there has been urinary tract infection or the function in the ipsilateral kidney is below normal (< or = 40%).
The operation consists of going through the bladder, dissecting the ureter and repositioning it in the bladder after excising the ‘blocked’ end of the ureter.
The success rate of this operation is 98%.
Complications in 2 % are:
- Continuing obstruction at the vesicoureteric junction called ‘J’ hooking requiring a reoperation to correct this.
- Continuing reflux despite the repositioning of the ureter. In this case we will have to reevaluate the situation with the patient h=whether to manage conservatively if there are no episodes of infection or proceed to re implant the ureter.
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