ABSTRACT
Antenatal and incidentally diagnosed megaureters can be safely treated conservatively after careful work up by combined imaging technics. Serial and repeated imaging are non the less usually necessary to confirm the diagnosis. This aspect could be fastidious and expensive. In case of symptoms, breakthrough infections or loss of kidney function, surgical treatment should be considered and good results can be expected. Refluxing megaureter has to be considered as high grade reflux and surgical approach is more often suggested. The authors have reviewed the experience of 139 patients with megaureters treated in the last decade to illustrate those facts.
Subject(s)
Ureteral Diseases/therapy , Child , Diagnostic Imaging , Dilatation, Pathologic/diagnosis , Dilatation, Pathologic/surgery , Dilatation, Pathologic/therapy , Female , Fetal Diseases/diagnosis , Humans , Kidney Diseases/etiology , Kidney Diseases/surgery , Male , Postoperative Complications , Prenatal Diagnosis , Retrospective Studies , Ureteral Diseases/diagnosis , Ureteral Diseases/surgery , Urinary Tract Infections/etiology , Urinary Tract Infections/surgery , Vesico-Ureteral Reflux/etiology , Vesico-Ureteral Reflux/surgeryABSTRACT
This article reviews the different thrombolytic agents currently available and the different mechanisms by which they activate the body's fibrinolytic system. The discussion is confined to the approach to the patient with venous thromboembolism using the different thrombolytic agents. Data are presented supporting the use of thrombolytic therapy and its long-term benefits, especially in patients with pulmonary embolism. A substantial portion of this article is devoted to practical considerations involved in the administration of thrombolytic therapy.
