Surgical treatment of the massively dilated primary megaureter in children.

From 1964 to 1975, of 83 children with primary megaureter 33 had unilateral and 8 bilateral massively dilated ureters that required surgical treatment, and of these 73% had febrile infection, 5% were septic and 10% were azotaemic. Surgical treatment consisted of ureteric reimplantation with excision of the atonic distal segment, preceded by diversion when indicated. Tailored reimplantation was successful in 98% of ureters and non-tailored reimplantation was uniformly unsuccessful. All failures were successfully corrected by tailored reimplantation. Thus the requirements for successful surgical management of massive ureteric dilatation in children secondary to an atonic ureteric segment are excision of the atonic segment, transvesical or extravesical tailoring of the ureter and reimplantation.