Long-Term Outcomes of Endoureterotomy in Children with Primary Obstructive Megaureter: A Single-Center Experience

PURPOSE: Endoureterotomy is an established surgical method for children with symptomatic or progressive primary obstructive megaureter (POM). The aim of this study is to evaluate the long-term outcomes and complications associated with endoureterotomy in children with POM. MATERIAL AND METHODS: In this retrospective single-center study, pediatric patients with POM who underwent endoureterotomy were evaluated for long-term complications and outcomes, including ultrasonographic and diuretic-enhanced renal scintigraphic findings. RESULTS: Among 178 megaureter cases, 41 POM patients (48 ureterovesical junction units) underwent surgery, including seven patients with bilateral involvement. The mean age of included patients was 26.67 months, with an average follow-up duration of 65.49 months. According to the predefined study endpoint, four units (8.33%) required secondary surgical intervention: two underwent re-endoureterotomy, one required ureterostomy, and one underwent pyeloplasty for persistent ureteropelvic junction obstruction. The long-term success rate after the initial endoureterotomy was 91.67%. CONCLUSION: This study suggests that endoureterotomy, as a minimally invasive surgical approach, provides favorable long-term ultrasonographic and scintigraphic outcomes with a high success rate in selected children with POM.