MINIMALLY INVASIVE TREATMENT OF LATE OBSTRUCTIVE COMPLICATIONS OF CHILDISH VESICOURETERAL REFLUX ENDOSCOPIC CORRECTION

Objective. To improve the results of treatment for delayed obstructive complications of childish vesicoureteral reflux endoscopic correction.

Materials and methods. The study included 22 pediatric patients with unilateral delayed obstruction of the ureter after endoscopic treatment for primary vesicoureteral reflux with dextranomer/hyaluronic acid copolymer (Deflux). The patients’ mean age was 63.0±36.2 months. The main group consisted of 12 children who underwent endoscopic removal of the bulking agent with ureteral stenting for 1 month as a minimally invasive treatment. The control group (historical control) included 10 patients who underwent only stenting of the dilated ureter.

Results. In the control group the ureterohydronephrosis resolution after the stent removal was observed in 2 (20.0%) children. The remained 8 (80.0%) patients with persistent significant dilatation of the ureter and renal pelvis were performed ureterocystoneoanastomosis. In the main group 8 (66.7%) patients showed a good result with absent reflux and dilated ureter. Ureteral reimplantation was necessary in 4 (33.3%) cases due to the persistent ureterohydronephrosis or the reflux development with obstruction resolving. The endoscopic surgery effectiveness was 20.0% in the stenting group and 66.7% in the implant removal group (p=0.043).

Conclusion. Endoscopic removal of the bulking agent is a minimally invasive, safe and quite effective procedure and it may be recommended as the treatment first line for delayed obstructive complications of the childish vesicoureteral reflux endoscopic correction.

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Автор(ы): V. I. Dubrov