Surgery for neuromuscular dysplasia

After some improvement in the condition, a decrease in the activity of the symptoms of pyelonephritis, a radical operation is performed, followed by a longer drainage of the operated ureter and bladder. In such patients, simultaneous surgery on both sides is effective, since in the postoperative period there is a very high risk of exacerbation of pyelonephritis or the development of its purulent forms in the kidney drained by the unoperated ureter. In those cases when the patient’s condition does not allow to simultaneously perform corrective surgery on both sides, a nephrostomy tube is applied on the second side.

Surgical intervention for neuromuscular dysplasia of the ureters should be considered as one stage in complex therapy. Before and after the operation, patients should be prescribed anti-inflammatory drugs strictly under the control of antibiotics. Young children (up to 3 years old) and older children with clinical manifestations of chronic renal failure in the immediate postoperative period, in addition to intensive antibacterial treatment, are shown infusion therapy for 5-7 days. It is necessary to control and correct the electrolyte composition of blood plasma, normalize the acid-base state. Blood transfusions are shown in fractional doses depending on the age of the child with an interval of 2-3 days, vitamin therapy. In order to more quickly sanitize the upper urinary tract, it is necessary to rinse the drainage tubes introduced into the ureters and bladder with a solution of dimethyl sulfoxide or other antiseptics. After discharge from the hospital, patients should be under the dispensary supervision of a urologist, and pediatric patients should be under the supervision of a pediatrician. Every 10-14 days, continuously for 10-12 months, it is necessary to carry out antibacterial treatment with a change of drugs, preferably based on the data of bacteriological analysis of urine and antibioticogram.