Prolonged drainage of the lower urinary tract in the treatment of refluxing megaureter in children

Abstract

The main purpose. To substantiate the need for conservative therapy as the first stage of treatment refluxing megoureter in newborns and infants. Materials and methods. Analyzed result s of treatment 19 children (25 ureters) with different levels of the disease. The evaluation criteria were the ultrasonographic researchers, determining the degree of dilatation of the ureters, the cup-and-pelvis system and the thickness of the kidney parenchyma, as well as the presence of an urinary tract infection. Treatment based on prolonged drainage and lower urinary tract catheter Folleya (up to 1 month), with the interleave instrument natural urination (also up to 1 month, or until the secondary acute pyelonephritis). Medication support was in an antibiotic therapy, taking into account with the sensitivity of microflora and preventive treatment uroseptics. There were regularly monitoring the degree of activity of the secondary flow of pyelonephritis and excretory function of the kidney. Excretory urography and cystography used in suspected degradation of structural parameters and renal function. Indications for surgical treatment were indestructible inflammatory process within one month, the progression of dilatation of the ureters and renal pelvis system, thinning and disruption of parenchymal renal excretory function. Results. In 6 (31,6%) of children to the age of 2 years were revealed a complete disappearance of dilatation of the ureter. In 3 cases of them survived vesicoureteral reflux 1- 2 degrees without renal impairment and without bladder syndrome, which can be considered as a positive treatment outcome. Conclusion. Treatment the newborns and infants with refluxing megaureter should begin with conservative therapy, including prolonged drainage of the lower urinary tract.