Factors associated with spontaneous resolution and surgery innon-obstructive non-refluxing megaureters

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Yıldız G., Torun Bayram M., Türker H. D., Kavukçu S., Soylu A.

PEDIATRICS INTERNATIONAL, vol.68, no.e70323., pp.1-7, 2026 (SCI-Expanded, Scopus)

  • Publication Type: Article / Article
  • Volume: 68 Issue: e70323.
  • Publication Date: 2026
  • Doi Number: 10.1111/ped.70323
  • Journal Name: PEDIATRICS INTERNATIONAL
  • Journal Indexes: Scopus, Science Citation Index Expanded (SCI-EXPANDED), BIOSIS, CINAHL, EMBASE, MEDLINE
  • Page Numbers: pp.1-7
  • Open Archive Collection: AVESIS Open Access Collection
  • Dokuz Eylül University Affiliated: Yes

Abstract

Objectives

Clinical and radiological criteria for predicting surgical approach or spontaneous resolution have been evaluated mainly in primary non-refluxing megaureters detected prenatally. We aimed to analyze these criteria in a retrospectively collected cohort of children with either prenatal or postnatal diagnosis of non-obstructive non-refluxing (NONR) megaureter.

Methods

Hospital files of the children with NONR megaureter were evaluated retrospectively for age at diagnosis, presenting complaint, follow-up period, accompanying urologic abnormalities, complications (renal scar and urinary tract infection), and final status.

Results

There were 27 NONR megaureters in 25 patients (male/female: 19/6; prenatal/postnatal: 18/7). Two prenatal cases had bilateral involvement. Spontaneous resolution rate in renal units was lower in postnatal cases than in prenatal cases (2 out of 7 vs. 15 out of 20, OR 7.5). Spontaneous resolution rate was also higher when ureteral diameter was <11 versus ≥11 mm (OR 10.9) and renal pelvis anteroposterior diameter ≤10 mm versus >10 mm (OR 19.2). Surgical intervention rate was higher in the presence of ureteral diameter ≥14 versus <14 mm (OR 22.0). Renal units that underwent surgical treatment showed higher rates of febrile urinary tract infections, renal scarring, and reduced renal function on 99mTc-MAG3 scintigraphy compared to those without surgical intervention.

Conclusions

Initial management of asymptomatic non-refluxing megaureters should be observational monitoring. Majority of them resolve spontaneously if ureteral diameter is <11 mm with renal pelvis anteroposterior diameter ≤10 mm. However, children with ureteral diameter ≥14 mm are prone to develop febrile urinary tract infection, renal scar, and decreased renal function requiring surgical intervention.