More than 200 methods of correction of the ureter with its dysplasia have been proposed. The choice of the method and method of surgical intervention is determined by the nature and degree of the clinical manifestation of the disease, the presence of complications, the general condition of the patient.
Conservative treatment of this malformation is unpromising. It can be used in the preoperative period, since with the most careful selection of antibacterial agents, it is possible to achieve remission of pyelonephritis for several weeks and very rarely for several months.
However, when establishing the normal function of the kidney (radioisotope research methods), it is advisable to temporarily abandon surgical treatment, since it is extremely difficult to carry out differential diagnostics between neuromuscular dysplasia of the ureter, functional obstruction of the ureter, disproportion of its growth in young children.
If the loss of kidney function is ascertained, surgical intervention is indicated.
Palliative operations (nephro-, pyelo-, uretero- and epicystostomy) are ineffective; radical methods of treatment of neuromuscular dysplasia of the ureters are shown. The best results are obtained in patients operated on in stages I and II of the disease. The overwhelming majority of patients are sent to the clinic for urological examination and treatment in the III or II stage of the disease. In stage III, the indications for surgery are relative, since at this time the process in the kidney and ureter is almost irreversible. Consequently, the effectiveness of treatment for megaloureter can be increased, first of all, by improving the diagnosis of this malformation, that is, by a wider introduction of uroradiological examination methods into the practice of somatic children’s hospitals and polyclinics. Surgical intervention is indicated at any age after diagnosis and preoperative preparation according to general requirements. Expectant tactics for this disease are unjustified. Plastic surgeries give the better results the earlier they are performed.