EFFICIENCY OF THE ENDOSOPIC CORRECTION OF HIGH-GRADE VESICOURETERAL REFLUX IN CHILDREN



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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.

作者简介

S. Zorkin

National Medical Research Center for Children’s Health

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Email: zorkin@nczd.ru
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D. Shakhnovsky

National Medical Research Center for Children’s Health

Email: noemail@neicon.ru
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F. Turov

National Medical Research Center for Children’s Health

Email: noemail@neicon.ru
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A. Galuzinskaya

National Medical Research Center for Children’s Health

Email: noemail@neicon.ru
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E. Dyakonova

National Medical Research Center for Children’s Health

Email: noemail@neicon.ru
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