MANAGEMENT OF THE DILATED URETER

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Abstract
Dilatation of the ureter in children may be caused by a variety of conditions. The most common causative factor is mechanical obstruction distal to the area of widening. The second most common factor is neuromuscular dysfunction. A third condition, in which obstruction cannot be demonstrated and no apparent disturbance of innervation is evidenced, has been recognized by urologists. Obstruction may occur at any level of the urinary tract; where obstruction is distal to the ureter, dilatation will frequently occur. This condition has often been called megaloureter, but the term hydroureter is more descriptive of the pathological process involved. HYDROURETER The increase of hydrostatic pressure in the urinary drainage system produces a progressive widening of the ureteral lumen; this dilatation is followed by elongation. As the process develops, angulation occurs, with production of convolutions or loops. These loops of ureter frequently become adherent through the formation of sheets of connective tissue.

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