Megaureter in Children
What is megaureter in children?
Megaureter is a ureter that is much wider than normal. The ureters are the tubes that
carry urine from the kidneys to the bladder. A ureter that is wider than 3/8 inch
is a megaureter. A megaureter may not drain urine normally. Urine may back up into
the kidneys. This can lead to infections and kidney damage.
What causes a megaureter in a child?
A megaureter occurs when a baby is growing in the uterus. A normal ureter has a layer
of muscle tissue. This muscle layer helps send urine down the tube with movement called
peristalsis. But part of this layer may be replaced with stiff, fibrous tissue instead.
This prevents normal peristalsis. A megaureter may also occur if there is a blockage
stopping urine from entering the bladder. This causes a backflow of urine toward the
kidney, widening the ureter.
A megaureter can occur on its own without other existing conditions. But it often
occurs along with other problems, such as prune belly syndrome.
What are the symptoms of megaureter in a child?
Symptoms can be a bit different for each child. They can include:
The symptoms of megaureter can seem like other health conditions. Take your child
to their healthcare provider for a diagnosis.
How is megaureter diagnosed in a child?
Often a megaureter is diagnosed by ultrasound while a woman is still pregnant. After
birth, some babies have other problems that mean they may have a megaureter. Children
who are diagnosed later often have urinary tract infections (UTIs). The healthcare
provider will ask about your child’s symptoms and health history. They will give your
child a physical exam. Your child may also have tests, such as:
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Intravenous pyelogram (IVP). This is an imaging test that uses an X-ray to look at the urinary tract. A contrast
dye is given so that the tract can be seen on film. An IVP also shows the rate and
path of urine flow through the urinary tract.
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CT scan. This is an imaging test that uses a series of X-rays. A computer then puts the X-rays
together to form detailed pictures of the abdomen and kidneys.
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Voiding cystourethrogram. This is a type of X-ray of the urinary tract. A thin, flexible tube (catheter) is
put in the tube that drains urine from the bladder to the outside of the body (urethra).
The bladder is filled with a liquid dye. X-ray images are taken as the bladder fills
and empties. The images will show if there is any reverse flow of urine into the ureters
and kidneys.
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Abdominal ultrasound. This imaging test looks at internal organs as they function and at blood flow through
blood vessels.
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Diuretic renal scan. This is a nuclear imaging test. It’s done by injecting a radioactive fluid into a
vein. The radioactive material is then carried to the kidneys, where it gives off
signals that can be captured with a special camera. During the scan, a diuretic medicine
is given to speed up urine flow through the kidneys. This helps show any blocked part
of the urinary tract.
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Blood and urine tests. These are done to check for UTI, check your child's electrolytes, and to see how your
child's kidneys are working.
How is megaureter treated in a child?
Treatment will depend on your child’s symptoms, age, and general health. It will also
depend on how severe the condition is.
Your child may need to take antibiotics to prevent urinary tract infections. In some
cases, the megaureter will go back to normal on its own over time. If there is a blockage
of the urinary tract, your child may need surgery. The surgery removes the part of
the ureter that is abnormal.
Talk with your child’s healthcare providers about the risks, benefits, and possible
side effects of all treatments.
What are possible complications of megaureter in a child?
Possible complications of megaureter include:
When should I call my child’s healthcare provider?
Call the healthcare provider if your child has:
Key points about megaureter in children
-
A megaureter is a ureter that is much wider than normal. A ureter that is wider than
3/8 inch is a megaureter.
-
It occurs when a baby is growing in the uterus.
-
Often it is diagnosed by ultrasound while a woman is still pregnant. Or your child
may also have imaging tests to look at the urinary tract.
-
It may not drain urine normally. Urine may back up into the kidneys. This can lead
to infections and kidney damage.
-
Your child may need to take antibiotics to prevent urinary tract infections. In some
cases, the megaureter will go back to normal on its own over time. If there is a blockage
of the urinary tract, your child may need surgery.
Next steps
Tips to help you get the most from a visit to your child’s healthcare provider:
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Know the reason for the visit and what you want to happen.
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Before your visit, write down questions you want answered.
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At the visit, write down the name of a new diagnosis, and any new medicines, treatments,
or tests. Also write down any new instructions your provider gives you for your child.
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Know why a new medicine or treatment is prescribed and how it will help your child.
Also know what the side effects are.
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Ask if your child’s condition can be treated in other ways.
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Know why a test or procedure is recommended and what the results could mean.
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Know what to expect if your child does not take the medicine or have the test or procedure.
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If your child has a follow-up appointment, write down the date, time, and purpose
for that visit.
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Know how you can contact your child’s healthcare provider after office hours, and
on weekends and holidays. This is important if your child becomes ill and you have
questions or need advice.