Сравнительный анализ результатов баллонной дилатации высокого давления при обструктивных уропатиях у детей: ОРИГИНАЛЬНЫЕ СТАТЬИ

Людмила Анатольевна Алексеева; Игорь Борисович Осипов; Дмитрий Анатольевич Лебедев; Сергей Александрович Сарычев; Виктор Владимирович Бурханов; Дмитрий Евгеньевич Красильников; Мария Владимировна Лифанова; Антон Игоревич Осипов; Анастасия Алексеевна Узинцева

doi:10.56871/PED.2025.58.97.002

Comparative analysis of high-pressure balloon dilation results in case of obstructive uropathies in children

ORIGINAL STUDIES

Lyudmila A. Alekseeva Saint Petersburg State Pediatric Medical University https://orcid.org/0000-0003-1006-828X
Igor B. Osipov Saint Petersburg State Pediatric Medical University https://orcid.org/0000-0002-1170-3436
Dmitry A. Lebedev Saint Petersburg State Pediatric Medical University https://orcid.org/0000-0003-4078-5116
Sergei A. Sarychev Saint Petersburg State Pediatric Medical University https://orcid.org/0000-0002-8723-2976
Viktor V. Burhanov Saint Petersburg State Pediatric Medical University https://orcid.org/0000-0002-0037-6724
Dmitry E. Krasilnikov Saint Petersburg State Pediatric Medical University https://orcid.org/0000-0001-6122-0216
Mariya V. Lifanova Saint Petersburg State Pediatric Medical University https://orcid.org/0000-0003-1626-7255
Anton I. Osipov Saint Petersburg State Pediatric Medical University https://orcid.org/0000-0002-6119-4254
Anastasia A. Uzintseva Saint Petersburg State Pediatric Medical University https://orcid.org/0000-0002-9530-5776

Keywords:

первичный обструктивный мегауретер гидронефроз эндоскопическое стентирование баллонная дилатация высокого давления primary obstructive megaureter hydronephrosis ureteral stent high pressure balloon dilation

Abstract

Background.The search for less invasive procedures for treatment obstructive uropathy is a priority in pediatric urology. One of the modern methods of defect correction is balloon dilation of ureteral stricture.

Aim. To compare the effectiveness of high-pressure balloon dilation in patients with obstructive uropathies in groups with primary obstructive megaureter and in patients with hydronephrosis

Materials and methods. In the pediatric urology clinic of St. Petersburg State Pediatric Medical University in 2018–2020, 73 patients diagnosed with obstructive uropathy of the upper urinary tract were treated with high-pressure balloon dilation. Of these, 57 were boys and 16 were girls. All patients were divided into two groups: 41 children with stage III–IV pelvic hydronephrosis and 32 with stage II–III primary obstructive megaureter.

Results. The effectiveness of the high-pressure balloon dilation was assessed after 6 months. Ultrasonography, excretory urography, and diuretic MAG3 renogram were performed.

A positive result among patients with hydronephrosis was recorded in 21 out of 41 patients (51%). The effectiveness of balloon dilation in children with hydronephrosis did not depend on the age of the patients. In 4 patients, indications were given for repeated balloon dilation of the pyeloureteral segment. Only one of the four patients achieved a positive result during the repeated procedure.

Out of 32 patients with primary obstructive megaureter, a good result was noted in 28, which amounted to 87%. This procedure was most effective in younger patients.

As shown by the data analysis, out of 24 patients with primary obstructive megaureter aged under 1.5 years, a good result was in 23, which amounted to 95.8%.

In both groups, unsatisfactory results were more often observed in patients with significant dilation of the pelvic kidney and parenchymal thinning.

Conclusion. Analysis of the results of high-pressure balloon dilation revealed the advantage of this method in patients in the group with primary obstructive megaureter (87% of positive results), while in patients with hydronephrosis, a positive result was achieved in 51%.

Repeated balloon dilation in most cases does not lead to an improvement in treatment results.

Author Biographies

Lyudmila A. Alekseeva, Saint Petersburg State Pediatric Medical University

MD, Ph D,
Associate Professor, Department of Urology

Igor B. Osipov, Saint Petersburg State Pediatric Medical University

MD, Ph D, Dr Med Sci, Professor, Head,
Department of Urology,

Dmitry A. Lebedev, Saint Petersburg State Pediatric Medical University

MD, Ph D, Dr Med Sci, Associate
Professor, Department of Urology

Sergei A. Sarychev, Saint Petersburg State Pediatric Medical University

MD, Ph D,
children surgeon-urologist Surgical Department No. 1

Viktor V. Burhanov, Saint Petersburg State Pediatric Medical University

MD, Ph D, Associate Professor,
Department of Urology

Dmitry E. Krasilnikov, Saint Petersburg State Pediatric Medical University

MD, Ph D, Associate Professor,
Department of Urology

Mariya V. Lifanova, Saint Petersburg State Pediatric Medical University

Assistant Professor, Department of Urology

Anton I. Osipov, Saint Petersburg State Pediatric Medical University

MD, Ph D, Associate Professor, Department of Urology,

Anastasia A. Uzintseva, Saint Petersburg State Pediatric Medical University

Assistant Professor, Department of Urology

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