[Plastic repair of the anterior abdominal wall in bladder exstrophy]. / Plastika perednei briushnoi stenki pri ékstrofii mochevogo puzyria.

In 1987-1993 surgical treatment for exstrophy of the bladder was performed in 35 children at the age 8 months--3 years. All the patients underwent one-stage transplantation of the ureters into the semi-isolated segment of the sigmoid colon with antireflux protection of the ostia, bladder extirpation and repair of the anterior abdominal wall. The most difficult stage of the intervention is repair of the abdominal wall defect after removal of the large bladder. Related complications arising in 16% of the surgical patients impose the problem of the technique of safe filling of the abdominal wall defect. In 16 patients with large bladder its demucosation was followed by strengthening of the detrusor muscles with the help of interrupted sutures with fixation to underdeveloped oblique abdominal muscles. The skin defects was filled by raised movable skin flaps on both sides of the divided pubis. The above technique reduced the number of postoperative complications three times. Intestinal eventration was not observed. The wound suppuration and partial defect of the sutures occurred in 1 case. The rest 15 children exhibited healing with minimal scarring and good cosmetic effect.

[Guided transcutaneous puncture biopsy of the kidneys under ultrasound control in children with nephrourological diseases]. / Pritsel'naia chreskozhnaia punktsionnaia bipsiia pochek pod kontrolem ul'trazvuka u detei s nefrourologicheskimi zabolevaniiami.

The results of 836 transcutaneous puncture renal biopsies in 277 children under 15 years of age demonstrate that the informative value of renal biopsies has risen from 91.6 to 95%, while the number of complications reduced from 26 to 4.9% due to modification of the biopsy techniques and ultrasound control.

[The classification of the urological diseases of newborn and nursing infants]. / K voprosu o klassifikatsii urologicheskikh zabolevanii novorozhdennykh i grudnykh detei.

In the attempt to classify most common urological diseases in neonates the authors have summarized more than 700 cases. The examinees' age ranged from a few hours to four months. The diagnosis was made antenatally or early in postnatal life according to the leading symptoms of abdominal, uropoietic, urination and urine quality defects. Depending on the urinary damage at different stages of intra- and extrauterine development and time of primary symptoms recognition, the authors propose to distinguish antenatal, intranatal and postnatal lesions. These include congenital conditions, dysfunctions, conditions caused by tissue and system immaturity, etc. Instructions on the choice of optimal therapeutic policy for each group are given.

[Endourethral correction of valvular obstruction in children]. / Endouretral'naia korrektsia klapannoi obstruktsii u detei.

Endourethral dissection of valvular cusps was carried out by means of an urethrotome in 34 boys with Type I and III valves of the posterior urethra. The indications for and the techniques of the dissection on depending on the type of the valve are discussed and measures for preventing complications are suggested. Endoscopic, radiological, and urodynamic methods of examination of the lower urinary tract determined the therapeutic tactics and help in evaluation of the efficacy of the operative treatment. The method allows correction in patients with valves to be performed in one stage in the compensated stage of the disease and after preliminary derivation of urine in the decompensated stage. The authors recommend optic urethrotomy for the treatment of children with valves of the posterior urethra.

[Prolapse of the urethral mucosa in girls]. / Vypadenie slizistoi uretry u devochek.

In the recent 9 years 39 girls aged from 2 to 10 years were treated at the clinic for prolapse of the urethral mucosa. Among them 24 had circular and 15 had segmental prolapse. The disease was encountered most frequently between 6 and 10 years of age, predominantly in the summer. Complex treatment was started with nonoperative measures which were followed by operation if the prolapse persisted or recurred. Spontaneous reduction of the mucosa occurred in 6 of 22 children who were treated by nonoperative measures, in 3 cases the effect was temporary and a recurrence developed. Operative excision of the mucosa was carried out in 36 girls. The results were good. The article discusses the etiopathogenesis of the disease and analyses the morphological changes in the removed urethral mucosa.

[Urinary diversion in infants]. / Otvedenie mochi u novorozhdennykh i grudnykh detei.

The article generalizes the experience in the treatment of over 500 children, aged from hours to 5 months, with various developmental anomalies of the urinary system. Different variants for draining off the urine were applied in 142 patients. Urethral, vesical, and supravesical methods are characterized. The indications for their use in the newborns and infants are formulated. Preference is given to the supravesical methods, among which T-ureterocutaneostomy and suspended ureteropyelostomy are optimal. The operative techniques are described. Complications occurred in 10 children: urinary dermatitis (3), cicatrization of the stoma (2), separation of the sutures of the main wound (2), stenosis of the stoma (1). The author concludes that draining off urine in the newborn with obstructive uropathy is advisable before radical correction of the anomaly.

[Diagnostic stages and special study methods in surgical diseases of children]. / Etapy diagnostiki i spetsial'nye metody issledovaniia khirurgicheskikh zabolevanii u detei.

The surgery in children should take into consideration 6 steps of diagnosing: initial, exact, subnarcotic, intraoperative, immediate postoperative and late postoperative steps when the growth of the child's organs and systems enable the final diagnosis to be established. Close attention to physically revealed symptoms of the disease may restrict the application of special methods and shows the skill of the physician.