It is advisable to combine oral administration of antibacterial agents with their local use by iontophoresis (iontophoresis of antiseptics, potassium iodide, neostigmine methyl sulfate, strychnine, inductothermy, electrical stimulation). The appointment of hyaluronidase, pyrimidine bases, aloe and other biogenic stimulants in the postoperative period helps to improve the blood supply to the operated ureter, reduce sclerosis and enhance reparative processes in the wall of the urinary tract and in the surrounding tissues.
Dispensary observation of patients who have undergone surgical treatment should be carried out by a urologist and nephrologist, and pediatric patients should be monitored by a pediatrician. Good patency of the PMS and the absence of exacerbations of pyelonephritis within 5 years allow the child to be removed from the register.
The postoperative prognosis for megaureter depends largely on the preservation of renal function.
VUR is a pathogenetic term that reflects the process of retrograde flow of urine from the bladder into the upper urinary tract. VUR is one of the most common diseases of the urinary system, especially in children.
VUR is a polietiologic disease.
The main cause of primary VUR is a congenital malformation of the orifice of the ureter:
- persistent gaping of the orifice (“funnel-shaped” configuration of the orifice of the ureter): o the location of the orifice of the ureter outside the Lieto triangle (dystopia of the orifice of the ureter);
- short submucosal tunnel of the intravesical ureter;
- doubling of the ureter;
- paraureteral diverticulum. The main causes of secondary VUR:
- organic IVO (valve or stricture of the urethra, sclerosis of the bladder neck, stenosis of the external opening of the urethra);
- dysfunction of the bladder (GMF, detrusor-sphincter discoordination);
- inflammation in the area of the Lieto triangle and the orifice of the ureter (with cystitis);
- wrinkling of the bladder (“microcystis”);
- iatrogenic damage to the area of the Lietot triangle and the orifice of the ureter (operations with dissection of the smooth muscles of the detrusor or impact on the orifice of the ureter: ureterocystoanastomosis, bougienage of the ureteral orifice, dissection of the ureterocele, etc.).