Каменеутворення в аугментованому сечовому міхурі в дитячому віці: сучасний стан проблеми

Abstract

Purpose - to analyze the current state of the problem patients’ treatment with stones in the augmented bladder and recommend optimal approaches for their elimination, based on the literature data. Augmentation cystoplasty is a surgical procedure used in adults and children with refractory bladder dysfunction, including, in particular, small bladder capacity, in whom conservative treatment has failed. The leading pediatric pathologies for which enterocystoplasty performed are neuropathic bladder and bladder exstrophy. The article examines the complications that arise, and the possibilities and advantages of endoscopic techniques in children compared to open surgery in view of compromised tissues due to congenital defects and previous surgical interventions. The cause of the main postoperative complications, such as metabolic disorders, hematuria syndrome, calculi formation, mucus formation, enteric fistulae, bladder rupture, intestinal obstruction and the development of malignant neoplasms, are mainly related to the use of gastrointestinal tract tissues in the bladder. As an example of modern surgical and minimally invasive methods application, considered the case of treatment of a child with urinary bladder exstrophy, in which later stones were formed. Conclusions. The stones formation in an augmented bladder is a fairly common problem, difficult to prevent and effectively treat. Timely complete bladder emptying and adequate treatment of bladder infections are the keys to preventing the formation of stones in an augmented bladder. Modern minimally invasive technologies make it possible to effectively, minimally traumatical and safely treat patients with calculi of various localizations of the urinary system, as well as patients who have previously undergone complex plastic surgery. The research was carried out in accordance with the principles of the Helsinki Declaration. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors.