Modern view on the problem of urine diversion in children with severe urinary disorders

Abstract

Urination is a complex multicomponent process. Urinary disorders often lead to serious consequences on the urinary system, social maladaptation, and impairment of the quality of children's lives. Due to the large number of pathologies leading to these disorders and the involvement of several systems (for example, the nervous system in myelodysplasia), the doctor must be extensively knowledgeable and experienced in related fields. Surgical methods of urinary diversion have a long history. Surgeons worldwide have been trying to solve this problem for many decades, but it remains relevant and unsolved. The wide variety of urinary disorders has a correspondingly impressive number of types and options of surgical interventions. The goals of these surgical techniques are to correct the anatomical and clinical aspects of the disorders and assure the childs socio-psychological adaptation. Surgeons must consider many factors such as all the pathogenetic nuances of an underlying disease, comorbidities, the childs constitutional features, prospects for his or her social adaptation, the family home environment, parents willingness to and focus on long and challenging treatment. Based on these details, it is evident that urinary diversion in children is a multifaceted problem. It requires a very careful and individualized approach to each patient to ensure choosing the optimal treatment method in each case. This choice will affect many aspects of the childs life, including his or her social adaptation, the ability to obtain an education and lead an almost normal lifestyle. The aim of this study is to review and systematize the accumulated knowledge on this subject.