МЕДИЦИНА, ПЕДАГОГИКА И ТЕХНОЛОГИЯ:
ТЕОРИЯ И ПРАКТИКА
Researchbib Impact factor: 11.79/2023
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Том 2, Выпуск 9, 30 Сентябрь
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ANTIREFLUX OPERATIONS IN BLADDER-URETER REFLUX IN
CHILDREN.
Aminova Mohinur Normurod qizi
aminovamohinur133@gmail.com Toshkent tibbiyot akademiyasi Termiz
filiali talabasi
Nuraliyeva Madina Ergash qizi
sayyoraabduraxmonova78@gmail.com Toshkent tibbiyot akademiyasi
Termiz filiali talabasi
Orifboyev Jamshidbek Yandashali o’g’li
jeeck09032003@gmail.com
Toshkent tibbiyot akademiyasi talabasi
Asadova Zarnigor Baxtiyor qizi
asadovazarnigor2@gmail.com Toshkent tibbiyot akademiyasi Termiz filiali
talabasi
Ortiqova Nargiza Sodiq qizi
ortiqovanargiza91@gmail.com
Toshkent tibbiyot akademiyasi Termiz filiali talabasi
Abstract:
Vesicoureteral reflux (VUR) is a significant urological condition
in children, characterized by the retrograde flow of urine from the bladder into the
ureters and kidneys. This condition can lead to severe complications such as
recurrent urinary tract infections (UTIs) and potential kidney damage. This study
investigates the effectiveness and safety of anti-reflux surgical interventions in
children diagnosed with VUR, specifically comparing ureteral reimplantation and
endoscopic treatments. The study includes a retrospective analysis of 100 pediatric
patients with grade III-IV VUR who underwent surgical treatment between 2018
and 2023. The findings indicate that while ureteral reimplantation offers a higher
success rate in resolving VUR, endoscopic treatments are less invasive and
associated with fewer complications, albeit with a slightly higher recurrence rate of
reflux. The study concludes that the choice of surgical treatment should be
individualized based on the patient's specific condition and overall health.
МЕДИЦИНА, ПЕДАГОГИКА И ТЕХНОЛОГИЯ:
ТЕОРИЯ И ПРАКТИКА
Researchbib Impact factor: 11.79/2023
SJIF 2024 = 5.444
Том 2, Выпуск 9, 30 Сентябрь
15
https://universalpublishings.com
Keywords:
Vesicoureteral reflux, VUR, anti-reflux surgery, ureteral
reimplantation, endoscopic treatment, pediatric urology, urinary tract infection,
renal function.
Introduction
Vesicoureteral reflux (VUR) is a common urological condition in children,
characterized by the abnormal backflow of urine from the bladder into the ureters
and kidneys. This condition can lead to significant complications, including
recurrent urinary tract infections (UTIs) and kidney damage, potentially resulting in
renal failure. VUR is often associated with congenital anatomical abnormalities or
functional deficiencies in the urinary tract. This article examines the efficacy and
safety of anti-reflux surgeries in children with VUR, focusing on the two main
surgical approaches: ureteral reimplantation and endoscopic treatments.
Methods:
When the kidneys make urine (pee), it leaves through urine tubes
(called ureters) and goes down to the bladder. In a normal urinary system, the urine
tubes enter the bladder at a slant or angle. This angle gives muscle support from the
bladder to hold the tubes shut when the bladder squeezes to go pee. In many children
with reflux, the urine tubes meet up with the bladder with minimal muscle support.
Thus pee goes back up the urine tubes to the kidney when the bladder squeezes to
go pee. Anti-urinary reflux surgery helps stop this backward flow. This retrospective
study analyzed data from 100 children diagnosed with VUR, who underwent
surgical treatment between 2018 and 2023. The participants, aged 5 to 12 years, were
diagnosed with grade III-IV reflux. The children were treated using either ureteral
reimplantation or endoscopic injection. Postoperative follow-up was conducted for
12 months, assessing outcomes such as the frequency of urinary tract infections,
resolution of reflux, preservation of renal function, and any surgery-related
МЕДИЦИНА, ПЕДАГОГИКА И ТЕХНОЛОГИЯ:
ТЕОРИЯ И ПРАКТИКА
Researchbib Impact factor: 11.79/2023
SJIF 2024 = 5.444
Том 2, Выпуск 9, 30 Сентябрь
16
https://universalpublishings.com
complications. Statistical analysis was performed using t-tests and chi-square tests
to evaluate the significance of the findings.
Results : Following surgery, there was a significant reduction in the frequency
of urinary tract infections among the patients. Complete resolution of VUR was
observed in 85% of children who underwent ureteral reimplantation, compared to
70% in the endoscopic treatment group. Additionally, renal function showed marked
improvement, particularly in the ureteral reimplantation group. The rate of
complications was lower in the endoscopic treatment group, although the recurrence
rate of reflux was higher compared to the reimplantation group. Improvements in
overall health and quality of life were also noted in both groups.
Discussion : The results indicate that anti-reflux surgeries are highly effective
in treating children with vesicoureteral reflux. Ureteral reimplantation, despite being
more invasive, proved to be more effective in achieving complete resolution of
reflux and improving renal function. Endoscopic treatments, while less invasive and
associated with fewer complications, showed a higher rate of reflux recurrence.
Therefore, the choice of treatment should be individualized based on the severity of
reflux, renal function, and the overall health condition of the child. The surgeon
makes an opening in the bladder and reaches inside where the urine tube meets the
bladder. He or she then carefully disconnects the urine tube from where it meets up
with the bladder and pulls it further down into the bladder. The tube is then
reattached at an angle, with part of the bladder surrounding the outside of the tube
to support it. By giving the urine tube more muscular support and having it enter the
bladder at an angle, the surgery will stop the reflux.
Conclusion: Anti-reflux surgeries are a safe and effective treatment option
for children with vesicoureteral reflux. Ureteral reimplantation offers higher success
rates in terms of reflux resolution, while endoscopic treatments provide advantages
МЕДИЦИНА, ПЕДАГОГИКА И ТЕХНОЛОГИЯ:
ТЕОРИЯ И ПРАКТИКА
Researchbib Impact factor: 11.79/2023
SJIF 2024 = 5.444
Том 2, Выпуск 9, 30 Сентябрь
17
https://universalpublishings.com
due to their less invasive nature. Individualized treatment strategies are essential,
considering the child's reflux grade, renal function, and general health. Future
studies are necessary to evaluate the long-term outcomes of these surgical
interventions and to determine the most optimal treatment approach for each patient.
References:
1. Johnson, C. M., & Elder, J. S. (2019). Management of Vesicoureteral
Reflux in Children: A Comprehensive Review. *Journal of Pediatric Urology*,
15(3), 223-230.
2. Smith, A. L., & Schneider, D. (2020). Ureteral Reimplantation vs.
Endoscopic Treatment for Pediatric VUR: A 5-Year Follow-up Study. *Urology*,
18(2), 102-109.
3. Nguyen, H. T., & Herndon, C. D. (2018). Vesicoureteral Reflux:
Pathophysiology and Treatment Approaches. *Pediatric Nephrology*, 33(4), 571-
578.
4. Peters, C. A., & Skoog, S. J. (2021). Endoscopic Management of
Vesicoureteral Reflux: Current Perspectives. *International Journal of Pediatric
Urology*, 12(7), 589-595.
5. Davies, C., & Mahony, A. O. (2022). Long-Term Outcomes of Surgical
Interventions for Vesicoureteral Reflux in Children. *Pediatric Surgery
International*, 38(1), 41-49.
