CLINICAL AND DIAGNOSTIC ASPECTS AND TACTICS TREATMENT OF URETEROCELE IN CHILDREN
Abstract
Ureterocele (UC) is a cyst-like enlargement of the submucosa of the ureter due to congenital stenosis of the ureteral orifice, characterized by enlargement of its distal part. The introduction of new technologies in pediatric practice has led to a significant improvement in the diagnosis and treatment of ureterocele in children. According to various authors, the frequency of their occurrence ranges from 1 to 4% of all urological patients. According to Cambele, the prevalence of UC is 1:4000. Ureterocele is detected in 80% of children with a doubled ureter and in 60% it is ectopic [2,4,10]. Despite the introduction of endourologic treatment methods, a number of clinicians point out emerging complications, after their implementation. Purpose of the study. Study was to improve the results of surgical treatment of ureterocele by studying the clinical course, creating a diagnostic protocol and developing optimal surgical tactics. Material and methods. We analyzed the results of treatment of 67 children with ureterocele (UC) aged from 1 to 18 years who were under treatment in the urological department of ODMC of Andijan city for the period from 2010-2023. Out of them boys were 25 (37.3%) and girls 42 (62.6%). Results. The data of clinical observation of two groups of patients depending on the type of surgery were analyzed. The main clinical group included children who underwent transurethral excision of ureterocele (TURU) - 38 patients. All patients underwent wide endoscopic dissection of ureterocele. Endoscopic intervention was considered successful in the absence of ureteral obstruction, PMR, urinary system infection. Conclusions. Observance of the developed algorithm of diagnostics and endoscopic correction allows to increase the efficiency of treatment, to reduce the number of complications in children. Endoscopic correction of ureterocele is a highly effective method of decompression and restoration of normal urodynamics of the upper urinary tract. Given the low traumatic nature, transurethral resection is the method of choice regardless of the type, nature and degree of ureterocele. After correction of the malformation, children are subject to mandatory dynamic monitoring and stage-by-stage examination for timely diagnosis and treatment of concomitant diseases and possible complications.
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