Minimally invasive methods for the treatment of obstructive ureterohydronephrosis in children
https://doi.org/10.52888/0514-2515-2023-356-1-29-33
Abstract
Purpose of the study. To evaluate the effectiveness of minimally invasive methods of treatment in children with congenital obstructive ureterohydronephrosis.
Material and research methods. We performed ureteral stenting in 78 (70.9%) children with congenital obstructive ureterohydronephrosis: I degree of ureterohydronephrosis -18 (23.0%), II degree -34 (43.6%) and III degree. -19 (24.3%), IV degree -7(9.0%). Children under the age of 16. Children with impaired urodynamics in the distal ureters underwent a complete clinical-biochemical laboratory and X-ray study.
Results of the study and their discussion. Stenting of the ureters was carried out in order to dynamically monitor the contraction of the urinary system. In children, stenting is performed under general anesthesia by performing cystoscopy. After assessing the topographic location of the orifice from the side of the pathology of the vesicoureteral segment, the ureteral orifice is expanded by balloon dilatation, followed by stenting of the ureter. It turned out to be effective in 26 (23.6%) children.
Conclusions. With neuromuscular dysplasia of the ureters in children of the first year of life, bougienage, balloon dilation of the ureterovesical fistula, followed by stenting of the ureter and pyelocaliceal system in 34.0% of patients lead to a significant improvement in urodynamics.
About the Authors
H. IbodovTajikistan
H. M. Mirakov
Tajikistan
T. Sh. Ikromov
Tajikistan
Ikromov T.Sh. – Doctor of Medical Sciences, Associate Professor; Director of State Institution «Republican Scientific and Clinical Center of Pediatrics and Pediatric Surgery»
Tel.: +992 888-801-501
N. S. Ibodov
Tajikistan
R. Rofiev
Tajikistan
References
1. Адаменко О.Б. Клинико - морфологическое обоснование консервативного лечения обструктивных заболеваний мочеточника у детей / О.Б.Адаменко // Российский вестник детской хирургии, анестезиологии и реаниматологии. – 2015. – Т. 5, №3. – С. 113–114.
2. Айнакулов А.Д. Дифференцированный подход к лечению первичного обструктивного мегауретера / А.Д. Айнакулов, Б.М. Майлыбаев // Детская хирургия. – 2014. –Т.18. –№5. – С. 16–18.
3. Киреева Н.Б., Хафизова Л.А., Заугаров М.Ю., Тибилов А.З. Тактика лечения нерефлексирующего мегауретера у детей.// Российски вестник детской хирургии, анестезиологии и реаниматологии, 2015. №2. - С. 73-74.
4. Коррекция нерефлюсирующего мегауретера у детей раннего возраста эндоскопическим методом / З.В. Бетанов [и др.] / Мегауретер у детей. – Рязань, 2019. – С.4.
5. Малоинвазивный метод лечения нерефлюксирующего мегауретера у младенцев / Л.Б. Меновщикова [и др.] // Пермский медицинский журнал. – 2015. – №2. – С.19 – 24.
6. Шкодкин С.В. Осложнения стентирования верхних мочевыводящих путей / С.В. Шкодкин, М.И. Коган, А.В. Любушкин // Урология. – 2015. – №1. – С. 94 – 99.
7. Эндоскопическая баллонная дилатация высокого давления как метод лечения первичного обструктивного мегауретера у детей / В.Ю. Сальников [и др.] // Журнал Педиатрия. – 2016. – Т. 95, №5. – С. 48 – 52.
8. Can endoscopic balloon dilation for primary obstructive megaureter be effective in along-term follow-up? / A. Bujons [et al.] // J. Pediatr. Urol. – 2015. – V.11, №1. –P. 37.
9. Castagnetti M. Double-J stent insertion across vesicoureteral junctione is it a valuable initial approach in neonates and infants with severe primary non refluxing megaureter / M. Castagnetti, M. Cimador, M. Sergio // Urology. – 2006. – V. 68, №4. – P. 870–875.
10. Endoscopic placement of double - J ureteric stents in children as a treatment for primary obstructive megaureter / D. Carroll, [et al.] // Urol. Ann. – 2010. – V. 2, №3. – P. 114–118.
11. Endoscopic balloon dilatation in primary obstructive megaureter: long-term results / I. Casal Beloy [et al.] // J. Pediatr. Urol. – 2018. – V. 14, №2. – P.167.
12. High pressure balloon dilatation of the uretero vesical junction in primary obstructive megaureter: Infectious morbidity / I. Kassite [et al.] // Prog. Urol. – 2017. – V. 27, №10. – P. 507–512.
13. Long-Term Outcomes in Primary Obstructive Megaureter Treated by Endoscopic Balloon Dilation. Experience Affer 100 Cases / R. Ortiz [et al.] // Front Pediatr. – 2018. – №6. – P. 275–280.
14. Primary obstructive megaureter: the role of high pressure balloon dilation / R.M. Romero [et al.] // J. Endourol. – 2014. – V. 28, №5. – P. 517–523.
Review
For citations:
Ibodov H., Mirakov H.M., Ikromov T.Sh., Ibodov N.S., Rofiev R. Minimally invasive methods for the treatment of obstructive ureterohydronephrosis in children. Health care of Tajikistan. 2023;(1):29-33. (In Russ.) https://doi.org/10.52888/0514-2515-2023-356-1-29-33