Primary obstructive megaureter (POM) is a prevalent cause of congenital hydroureteronephrosis, characterized by the dilation of the ureter proximal to a narrowing at the vesicoureteral junction (VUJ).
This study investigates the hypothesis that the absence of ganglion cells in the distal ureter contributes to the pathogenesis of POM, leading to impaired peristalsis and functional obstruction.
A prospective, observational study was conducted at Kanti Children’s Hospital, involving 16 patients diagnosed with primary megaureter. Distal ureter biopsies were collected intraoperatively and examined using hematoxylin and eosin (H&E) staining to identify the presence of ganglion cells.
All 16 patients (100%) demonstrated complete absence of ganglion cells in the distal ureter. Patients ranged in age from 9 to 132 months (median age: 36 months), with a male-to-female ratio of 1.7:1. Right-to-left side involvement ratio was 1:3.
Absence of ganglion cells may contribute to persistent functional obstruction in POM. Early surgical intervention may be warranted in such cases. Further research with advanced histological methods is necessary.
Keywords: megaureter, primary, obstruction
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