[Original experience in plastic surgery of pelviureteral segment in hydronephrosis in children].

The study of postoperative urodynamics of the upper urinary tract was made in 339 patients with obstruction of the pyeloureteral segment and on experimental animals (morphological tests). This study revealed factors deteriorating functional capacity of anastomosis in early postoperative period. The findings allow the surgeons to update the technique of the pyeloureteral segment resection and uretero-pyeloanastomosis, to determine indications for applying nonsteroid anti-inflammatory drugs in the postoperative period, to reveal advantages and establish indications for drainage-free pyeloplasty. Thus, use of drainage-free modified technique of pyeloplasty in certain indications is a safe and less traumatic method of the patients' management which increases efficacy of Anderson-Hines operation.

[The treatment of bladder exstrophy]. / Lechenie ékstrofii mochevogo puzyria.

The results of treatment of 41 children with vesical exstrophy were analysed. Four types of surgeries were performed: 1) transplantation of Lieutaud's triangle into the sigmoid (n = 19); 2) its transplantation into the semi-isolated part of the sigmoid (n = 7); 3) ureteral transplantation into the sigmoid (n = 3); 4) the formation of the urinary bladder and ureter from the adjacent tissues (n = 12). In the first group 2 children died, 6 patients had no clinical signs of chronic renal or ureteral inflammation for the period of 5-17 years, the remaining 11 patients had pyelonephritis. In the second group 5 children were apparently healthy for 1-3 years after the operation, one child developed pyelonephritis, one child died from pneumonia. In the third group 2 patients were apparently healthy 1.5-2 years after the surgery, 1 child developed pyelonephritis. A great number of complications such as sutural incompetence followed by fistulization or enuresis made the authors avoid the fourth type. Thus, while forming an urointestinal anastomosis, preference is given to transplantation of Lieutaud's triangle or ureters proper into the semi-isolated segment according to the antireflux methods, if there are strictures in their distal portions.