[The role of echography in the diagnosis of vesico-ureteral reflux in children]. / Rol' ékhografii v diagnostike puzyrno-mochetochnikovogo refliuksa u detei.

A study was made of alternative potentialities of ultrasonography in the diagnosis of vesicoureteral reflex (VUR) in 137 children (228 kidneys) aged 16 days to 14 years. Routine scanning of the urinary tract was performed; the dynamics of dilatation of the renal pelvis was estimated depending on the degree of the urinary bladder filling and urination; contrast sonography was carried out. Complex ultrasonography was informative in 33% of cases with grade I VUR, in 79% of cases with grade II VUR, and in 100% of cases with grade III-V VUR. It is suggested that in accordance with the ultrasonography data, VUR can be distributed into three main groups.

[Characteristics of the hydrodynamic situation in the urinary tract in vesico-ureteral reflux based on an analysis of a general type of equation of the linear transport model]. / Kharakteristika gidrodinamicheskoi situatsii v mochevykh putiakh pri puzyrno-mochetochnikovom refliukse na osnovanii analiza uravneniia obshchego vida lineinoi transportnoi modeli.

Upper urinary tract urodynamics are described through a linear deterministic chamber model. An analysis of possible urodynamic variants in vesico-ureteral reflux (VUR), using a mathematical model, has suggested that hydrodynamic situation in the refluxing ureter will be dependent on vesical and ureteral activity where ureterovesical incompetence and VUR are of similar grades. Where ureteral anatomy and function remain fairly intact, urinary regurgitation under high pressure shall be accompanied by the development of a considerable intraureteral hypertension. Besides, VUR-associated urodynamic disorder must have an obstructive component whose markedness will depend on the extent of arterial motor impairment, intravesical hypertension or a combination of the two. Urodynamic and radioisotopic studies have completely confirmed the theoretical postulations. In second- or third-degree VUR, for example, the highest intraureteral pressure developed in children with uninhibited bladder, while in fourth-degree VUR the bladder showed no response to gradual intravesical pressure rise. Urodynamic disturbance was already shown to have a functional/obstructive component in those cases of second-degree VUR where the bladder was uninhibited and be free of it in cases of normal bladder reflex and third-degree VUR.

[Bilateral obstructive diseases of the upper urinary tract in children]. / Dvukhstoronnie obstruktivnye zabolevaniia verkhnikh mochevykh putei u detei.

The authors examined 371 children aged 4 days to 15 years with obstructive diseases of the urinary tract. In 51 out of them there was bilateral hydronephrosis and 54 had bilateral obstructive megaureter. A new uretero-pelvic anastomosis was made in 47 children with bilateral hydronephrosis, in 31 out of them it was created successively. Resection of the pelvis was performed in 5 cases. Principles of the stepwise operative treatment are described as well as indications to a plasty without drainage in hydronephrosis. Operations were performed on 46 patients (92 ureters) with obstructive megaureter, 8 patients were treated conservatively. The conservative treatment is thought by the authors to be expedient in patients with compensated disturbance of urodynamics of the upper urinary tracts in obstructive megaureter and the every year rentgen-urodynamic control. Ureterocystoneostomy is indicated only in a progressing course of the disease.