LOW-INVASIVE METHOD FOR TREATMENT OF INFANTILE NONREFLEXING MEGAURETER

Aim. To determine the efficiency of the method of endoscopic bougienage and stenting of the ureteral orifice. Materials and methods. 224 infants under one year (134 boys and 90 girls) with primary megaureter were examined. Diagnostic protocol included both clinicolaboratory and instrumental methods (ultrasonic investigation with assessment of intrarenal blood flow compared to reservoir and evacuatory urinary bladder function) as well as x-ray methods. During examination and dynamic follow-up, all patients were divided into three groups: group 1 - 68 (40,6 %) patients including those with vesico-dependent forms of megaureter for dynamic follow-up and correction of intravesical hypertension; group 2 - 15 (8,8 %) infants operated for presence of organic obstruction; group 3 - 86 (50,6 %) infants treated with endoscopic bougienage and ureteral orifice stenting. Results. Positive result of endoscopic stenting was reached in 78 infants that made 90,3%. In connection with inefficiency of endoscopic treatment, preservation of ureter delatation, decrease in renal function, 5 patients needed operative treatment after stenting, 3 patients are still followed-up. No complications when using the method of endoscopic bougienage and stenting of the distal ureteral parts were registered. Conclusions. Thus, use of low-invasive methods of endoscopic bougienage and stenting of the distal ureteral parts in treatment of early age infants with primary obstructive megaureter promotes restoration of urodynamics of the upper urinary tracts, reduction in the number of infectious complications that prevents progression of chronic renal disease.

Primary obstructive megaureter, endoscopic bougienage, ureteral orifice stenting, complications