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EFFICIENCY OF THE ENDOSOPIC CORRECTION OF HIGH-GRADE VESICOURETERAL REFLUX IN CHILDREN
- Authors: Zorkin S.N.1, Shakhnovsky D.S.1, Turov F.O.1, Galuzinskaya A.T.1, Dyakonova E.Y.1
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Affiliations:
- National Medical Research Center for Children’s Health
- Issue: Vol 24, No 5 (2020)
- Pages: 292-296
- Section: ORIGINAL ARTICLES
- Submitted: 05.03.2021
- Published: 05.10.2020
- URL: https://jps-nmp.ru/jour/article/view/245
- DOI: https://doi.org/10.18821/1560-9510-2020-24-5-292-296
- ID: 245
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Abstract
Introduction. The endoscopic correction of vesicoureteral reflux in children has become a basic treatment technique. Its effectiveness in the low-grade reflux is high. High-grade refluxes are an indication for antireflux reconstructive plastic surgery. The article analyzes outomes of endoscopic treatment of patients with high-grade retrograde urine reflux. Material and methods. A total number of 307 patients (409 ureters) with IV-V grade of vesicoureteral reflux were treated. 156 girls and 151 boys, aged 4 months - 12 years, had the endoscopic correction with Dextranomer and Copolymer of Polyacrylic Polyvinyl Alcohol (PPC). The renal parenchyma damage was assessed with DMSA scan; urinary tract infection - with clinical and laboratory findings (febrile temperature and bacteriuria). Outcomes of treatment were evaluated with micurating cystography performed six months later. It revealed either no reflux or its lower grade - grade one. Average follow-up period was 5. 5 years. Results. The effectiveness of endoscopic correction of vesicoureteral reflux after the first injection was 68.7%. The second injection was effective in 48.9%. Febrile urinary tract infection after the treatment went down up to 6.2%. Marked bacteriuria remained high - 55.3%. Renal parenchyma structural and functional damage was noted in 38.9% of older children; mild and moderate degrees of damage prevailed (45.6% and 40.8%, respectively). Conclusion. The endoscopic correction of high-grade vesicoureteral reflux is recommended as the first line treatment for retrograde urine reflux. This technique is highly effective and minimally invasive.
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About the authors
S. N. Zorkin
National Medical Research Center for Children’s Health
Author for correspondence.
Email: zorkin@nczd.ru
Россия
D. S. Shakhnovsky
National Medical Research Center for Children’s Health
Email: noemail@neicon.ru
Россия
F. O. Turov
National Medical Research Center for Children’s Health
Email: noemail@neicon.ru
Россия
A. T. Galuzinskaya
National Medical Research Center for Children’s Health
Email: noemail@neicon.ru
Россия
E. Yu. Dyakonova
National Medical Research Center for Children’s Health
Email: noemail@neicon.ru
Россия
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