{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T12:18:59Z","timestamp":1788437939757,"version":"build-2803163510"},"reference-count":14,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T00:00:00Z","timestamp":1784160000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,9]]},"abstract":"\n A\n BSTRACT<\/jats:sc>\n <\/jats:title>\n \n Purpose:<\/jats:title>\n A ureter diameter exceeding 6 mm is termed megaureter. This study aimed to evaluate the clinical features of primary non-refluxing megaureter (PNMU) and the importance of ureteral diameter in its management.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n Clinical, radiological, and operative findings and long-term outcomes of PNMU followed or operated on between 2011 and 2023 were evaluated retrospectively. Patients with vesicoureteral reflux, a history of lower urinary tract pathology or surgery, and a follow-up <18 months were excluded.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Among 32 patients (12.5% female, 87.5% male), 50% were diagnosed prenatally. Twenty-six patients had unilateral, six had bilateral megaureters. Over a mean follow-up of 94.3 \u00b1 53.4 months, 37.5% were managed conservatively, 62.5% required intervention. Nine underwent open surgery, 11 underwent double-J-stenting. Median operation age was comparable between surgical groups (\n P<\/jats:italic>\n > 0.05) but significantly lower in patients with urinary tract infection (\n P<\/jats:italic>\n : 0.007). Ureteral diameter decreased from 10.4 mm (range: 6.2\u201324.2) to 6.9 mm (range: 0\u201317) in conservatively managed cases, from 11 mm (range: 8\u201324.2) to 9 mm (range: 0\u201319) in double-J-stent group, and from 9.7 mm (range: 6.2\u201318.8) to 4.3 mm (range: 0\u201313) in the open surgery group (\n P<\/jats:italic>\n > 0.05). No significant difference was observed among the peak measured ureter diameters in the conservatively managed group (median: 12 mm, range: 9\u201333), preoperative ureter diameters in the double-J-stent group (median: 12.5 mm, range: 8.8\u201317), and open surgery group (median: 14 mm, range: 8\u201331) (\n P<\/jats:italic>\n > 0.05).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Ureteral diameter has limited importance in PNMU management. Conservative management may be an option even in advanced dilatations. Postoperative ureteral dilatation may persist at varying levels and durations.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/jiaps.jiaps_27_26","type":"journal-article","created":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T06:00:30Z","timestamp":1784268030000},"page":"839-843","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Primary Nonrefluxing Megaureter: Does Ureter Diameter Really Matter?"],"prefix":"10.4103","volume":"31","author":[{"given":"G\u00fcl \u0130layda","family":"Sarar","sequence":"first","affiliation":[{"name":"Department of Pediatric Surgery, Zeynep Kamil Maternity and Children\u2019s Diseases Training and Research Center, University of Health Sciences, Istanbul, Turkey"},{"name":"Department of Pediatric Surgery, A\u011fr\u0131 Training and Research Center, A\u011fr\u0131, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serdar","family":"Moralio\u011flu","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Zeynep Kamil Maternity and Children\u2019s Diseases Training and Research Center, University of Health Sciences, Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,7,16]]},"reference":[{"key":"R1-20260903","first-page":"3","article-title":"Report of working party to establish an international nomenclature for the large ureter","volume":"13","author":"Smith","year":"1977","journal-title":"Birth Defects Orig Artic Ser"},{"key":"R2-20260903","doi-asserted-by":"crossref","first-page":"2029","DOI":"10.1007\/s00431-024-05494-7","article-title":"Primary non-refluxing megaureter: Natural history, follow-up and treatment","volume":"183","author":"Rivetti","year":"2024","journal-title":"Eur J Pediatr"},{"key":"R3-20260903","doi-asserted-by":"crossref","first-page":"1353","DOI":"10.1097\/01.ju.0000152319.72909.52","article-title":"Prenatally detected primary megaureter: A role for extended followup","volume":"173","author":"Shukla","year":"2005","journal-title":"J Urol"},{"key":"R4-20260903","doi-asserted-by":"crossref","first-page":"1743","DOI":"10.1007\/s11255-016-1384-y","article-title":"Primary non-refluxive megaureter in children: Single-center experience and follow-up of 212 patients","volume":"48","author":"Rubenwolf","year":"2016","journal-title":"Int Urol Nephrol"},{"key":"R5-20260903","doi-asserted-by":"crossref","first-page":"1021","DOI":"10.1016\/j.juro.2013.03.008","article-title":"Long-term followup of primary nonrefluxing megaureter","volume":"190","author":"Di Renzo","year":"2013","journal-title":"J Urol"},{"key":"R6-20260903","doi-asserted-by":"crossref","first-page":"126","DOI":"10.3389\/fped.2019.00126","article-title":"Primary non-refluxing megaureter: Analysis of risk factors for spontaneous resolution and surgical intervention","volume":"7","author":"Dekirmendjian","year":"2019","journal-title":"Front Pediatr"},{"key":"R7-20260903","doi-asserted-by":"crossref","first-page":"1300","DOI":"10.1016\/j.juro.2015.11.049","article-title":"The fate of primary nonrefluxing megaureter: A prospective outcome analysis of the rate of urinary tract infections, surgical indications and time to resolution","volume":"195","author":"Braga","year":"2016","journal-title":"J Urol"},{"key":"R8-20260903","first-page":"5","article-title":"Febrile urinary tract infections in children with primary non-refluxing megaureter: A systematic review and meta-analysis","volume":"234","author":"Rohner","year":"2020","journal-title":"Klin P\u00e4diatr"},{"key":"R9-20260903","doi-asserted-by":"crossref","first-page":"3549","DOI":"10.1007\/s00467-023-05938-6","article-title":"Non-surgical management in children with non-refluxing primary megaureter: A systematic review and meta-analysis","volume":"38","author":"Buder","year":"2023","journal-title":"Pediatr Nephrol"},{"key":"R10-20260903","doi-asserted-by":"crossref","first-page":"1766","DOI":"10.1016\/j.juro.2014.10.091","article-title":"Risk factors for febrile urinary tract infection in children with prenatal hydronephrosis: A prospective study","volume":"193","author":"Braga","year":"2015","journal-title":"J Urol"},{"key":"R11-20260903","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1016\/j.jpurol.2013.09.018","article-title":"British Association of Paediatric Urologists consensus statement on the management of the primary obstructive megaureter","volume":"10","author":"Farrugia","year":"2014","journal-title":"J Pediatr Urol"},{"key":"R12-20260903","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1016\/j.jpurol.2010.04.015","article-title":"The utilization of stents in the management of primary obstructive megaureters requiring intervention before 1 year of age","volume":"7","author":"Farrugia","year":"2011","journal-title":"J Pediatr Urol"},{"key":"R13-20260903","doi-asserted-by":"crossref","first-page":"870","DOI":"10.1016\/j.urology.2006.05.052","article-title":"Double-J stent insertion across vesicoureteral junction \u2013 Is it a valuable initial approach in neonates and infants with severe primary nonrefluxing megaureter?","volume":"68","author":"Castagnetti","year":"2006","journal-title":"Urology"},{"key":"R14-20260903","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1016\/j.urology.2013.08.087","article-title":"Coexisting ureteropelvic junction obstruction and ureterovesical junction obstruction: Is pyeloplasty always the preferred initial surgery?","volume":"83","author":"Lee","year":"2014","journal-title":"Urology"}],"container-title":["Journal of Indian Association of Pediatric Surgeons"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jiaps.jiaps_27_26","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T12:03:31Z","timestamp":1788437011000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jiaps.jiaps_27_26"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,16]]},"references-count":14,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/jiaps.jiaps_27_26","relation":{},"ISSN":["0971-9261","1998-3891"],"issn-type":[{"value":"0971-9261","type":"print"},{"value":"1998-3891","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,16]]},"assertion":[{"value":"2026-01-15","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-26","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}