METHOD FOR ASSESSING SEVERITY OF UPPER URINARY TRACT URODYNAMICS IN CHILDREN OF THE FIRST THREE YEARS OF LIFE WITH CONGENITAL HYDRONEPHROSIS AND METHOD FOR SELECTING THEIR TREATMENT TACTICS

摘要

FIELD: medicine.;SUBSTANCE: inventions group relates to medicine, namely to pediatric urology, and can be used for preoperative and postoperative assessment of the severity of upper urinary tract urodynamic disorders in children of the first three years of life with congenital hydronephrosis and the choice of subsequent treatment tactics. For this purpose, a method is proposed for assessing the severity of urodynamic disorders, including determining the coefficient of efficiency of emptying the pelvis Ce, the coefficient of adaptation of the pelvis to an increased urine flow Ca and the transient coefficient of the pyeloureteral segment of the ureter Cpus according to the formulas, followed by assigning points to the obtained values ​​of the coefficients Ce, Ca or Cpus and summing the scores obtained. With a score of 1 to 3, the first (I) minor degree of functional insufficiency of the upper urinary tract is diagnosed, from 4 to 6 points - the second (II) moderate degree of functional insufficiency of the upper urinary tract, from 7 to 9 points - the third (III) severe degree functional insufficiency of the upper urinary tract and with a score of 10 to 12, the fourth (IV) severe degree of functional insufficiency of the upper urinary tract is diagnosed. Also proposed is a method for choosing treatment tactics in accordance with the results of assessing the severity of urodynamic disorders. When diagnosing a severe degree, transurethral stenting (TUS) of the upper urinary tract is performed. When diagnosing a moderate degree, the patient is dynamically monitored at least once every 6 months with a re-assessment of the degree of urodynamic impairment and, while maintaining the total score of urodynamic insufficiency, treatment is carried out using the TUS method, with an increase in the total score by at least 2, pyeloplasty is performed.;EFFECT: inventions group provides a quick and objective assessment of the severity of upper urinary tract urodynamic disorders, which makes it possible to optimize treatment tactics and select the optimal method for surgical treatment.;2 cl, 15 dwg, 5 tbl, 2 ex