Minimal invasive operations in infants with congenital urinary tract disorders

Abstract

Purpose.To rate retrospectively the results of using minimally invasive surgical operation in treatment of obstructive disorders in infants. Materials and methods. From 2007 to 2016 1057 patientes (257 boys and 614 girls) with a mean age of 5.5 month (range 1m – 5 years) were treated. The patients were classified on four groups: the first - 69 boys with posterior urethral valve associated urodynamics disorders; the second group – 67 patientes with duplication and ureterocele; the third group - 170 patientes with congenital nonrefluxing megaureter; the fouth - 751 patientes with VUR. In all cases minimal invasive surgeries were preferable: transurethral primary valve ablation; endoscopic incision ureterocele, one-J-stending megaureter, endoscopic correction of vesicoureteral reflux with bulking agents. Results. Transurethral resection of the posterior urethral valve was performed for all patients of the first group - for 56 (81,2%) in one step, for 13 (18,8%) in two steps. Transurethral resection of ureterocele was performed in 53 patients (79,1%) of the second group.132 patients in the third group was treated with stended of ureter, endoscopic correction of vesicoureteral reflux with bulking agents was performed for patients of the fourth group: collagen for 454 patients (605 ureters), Urodex for 122 patients (189 ureters) and Vantris for 76 patients (121 ureters). The patients were followed according with to a program with repeated US, renal scintigrams (DMSA), frequency/volume chart observation. These investigations were assessed in 4-8-12 and 24 weeks. Antibacterial prophylactics were given and recurrent UTIs were registered, In 76 cases (7,2% ) when the disorder wasn’t eliminated, minimal invasive reoperation or open surgeries were carry out. Conclusions. Minimal invasive surgical operations can be performed in babies. They allow to normalize urodynamics and high success rate can be achieved avoid complex reconstractiv operations.