Megaureter| Diagnosis & Treatment

How is megaureter diagnosed?

If your child has been referred to a specialist who suspects megaureter, there will be a complete evaluation of the urinary tract. The initial evaluation typically includes an ultrasound of the kidneys, ureters and bladder.

Other studies are usually needed to confirm the diagnosis and determine the cause. These may include:

  • Voiding cystourethrogram (VCUG) is a specialized x-ray. It is used to determine whether vesicoureteral reflux (backward flow of urine from the bladder to the ureter and/or kidney) may be causing the problem.
  • A kidney scan is used to evaluate the degree of obstruction at the junction where the ureter meets the bladder. This scan also provides very detailed information about kidney function.

Once the doctor has checked for vesicoureteral reflux and obstruction, she will assign your child's megaureter or dilated upper urinary tract into one of the four following categories:

  • refluxing megaureter: vesicoureteral reflux alone is responsible for the megaureter
  • obstructed megaureter: significant blockage at the ureterovesical junction (UVJ) alone is responsible
  • refluxing and obstructed megaureter: both vesicoureteral reflux and blockage at the UVJ are present
  • nonrefluxing and nonobstructed megaureter: the upper urinary tract is dilated (wider than normal) but there is no evidence of vesicoureteral reflux or clinically significant obstruction

Even after the cause of your child's megaureter is determined, the doctor may want to perform additional tests to get a more complete picture of kidney and bladder function. These tests may include:

  • specialized renal scans and/or laboratory tests of your child’s blood and urine
  • blood testing to evaluate how well the kidney functions to filter blood
  • urodynamic evaluation to measure how well the bladder stores and empties urine
  • MRI (magnetic resonance imaging) to evaluate the detailed anatomy of the kidneys, ureters, and bladder in relation to surrounding structures

How is megaureter treated?

Treatment depends on the cause of the megaureter. In some cases, the condition clears up on its own. If this is the case, it is important to follow the doctor’s advice and bring your child in for follow-up visits as recommended.

If your child’s ureter is blocked, they may need surgery to remove the blockage. It is often possible to delay surgery until a child is at least 12 months old.

If your child has reflux (urine traveling backwards up the ureter), they may be given a once daily antibiotic. This will help prevent a urinary tract infection (UTI).