R.A. Nakonechnyy

The efficiency of mini-invasive treatment of vesicoureteral reflux in children

Vesicoureteral reflux (VUR) is subject of topical discussions about the searching for new and improving existing methods of diagnosis and treatment.

Purpose - to increase efficiency of treatment children with different clinical forms of vesico-ureteral reflux for an adequate development and functioning of kidneys through the optimization of intravesical interventions based on the clinical course of the disease and diagnostic criteria.

The study involved 270 children with different clinical forms of VUR II-IV stages in the age from 6 months to 14 years. Depending on the stage of vesico-ureteral reflux, research methods and methods of treatment, patients were examined before treatment (I period) on 3 day (II period) and 6 months (III period) after intravesical intervention.

In intravesical treatment of VUR II-IV stages we used such mini-invasive techniques as STING (subureteric injection), HIT (Hydrodistention Implantation Technique), Double HIT, and if necessary their combination. Type of intervention was determined intraoperatively depending on the degree of VUR and cystoscopic picture. The special attention was paid to the level of ureteral orifice hydrodistention. Usually at low grades of VUR and low levels of ureteral orifice hydrodistention was sufficient conventional STING technique. Instead, at higher grades, we used HIT and Double HIT techniques.

An ultrasound examination of the urinary tract in combination with analysis of ureteral jets allows to monitor VUR and reduce percentage of children unfounded roentgenological surveys, such as cystography.

Reduction the stage of VUR on order after the intravesical correction and improving clinical and laboratory parameters should be considered as positive result.

The efficiency of mini-invasive treatment ofVUR II-IV stages in children is high enough and after one implantation it reaches 68.89%.