V.F. Peterburgskyy, V.D. Malischuk, V.V. Golovkevich, T.P. Ovsiychuk, G.I. Guivan

Extravesical ureteroneocystostomy in the operative management of the congenital malformations of the ureterovesical segment in children

Aim: To estimate the efficiency of the extravesical ureteroneocystostomy techniques with taking into account the terms of the postoperative bladder function recovery.

Material and methods.The results of the extravesical ureteroneocystostomy techniques (Barry-40, modified Zaontz procedure - 23 ureters) performed in 58 (63 ureters) children with obstructed and refluxing megaureter aged 1.5- 13 yrs were analyzed in terms of their efficacy in upper urinary tract and postoperative bladder function recovery. The upper urinary tract was followed with ultrasound over 3, 6 and with intravenous urogram (IVU) and voiding cystourethrography (VCUG) in 12-months post surgery. Voiding efficacy and post voiding residuals (PVR) were estimated on 1, 3 and 10-14 day after urethral catheter removal.

Results. In 60 of 63 cases (95, 2%) the upper urinary tract seemed to be improved on ultrasound and IVU. 2 cases were operated on as secondary obstruction occurred and 1 - submitted to subureteral reflux correction. The voiding efficiency was low on 1, 3 day and showed improvement up to 10-14 day after voiding renewal. PVR also demonstrated normal parameters in these terms.

Conclusion. The extravesical ureteroneo-cystostomy techniques proved their efficacy in terms of upper urinary tract flow correction both in obstructed and refluxing megaureters. The urinary bladder function normalization occurs up to 10-14 day after voiding renewal.