[Surgical treatment of appendicular peritonitis in children]. / Khirurgicheskoe lechenie appendikuliarnogo peritonita u detei.

The article is based on the results of 10-year use of the method of aspiration drainage of the abdominal cavity in the treatment of 980 children with purulent peritonitis of appendicular origin. The authors used only a polymer tube to drain the cavity of the true pelvis and in principle did not resort to intraoperative irrigation of the abdominal cavity, postoperative lavage, and intraperitoneal injection of antibiotics. Postoperative complications were recognized in the early stages of development and were treated by nonoperative methods on the main. The number of relaparotomies was 0.83% of the total number of operations for appendectomy. The described method meets the principles of pediatric surgery most fully, is more sparing than the other methods, and the authors recommend it for wide introduction into practice.

[Electrophysiologic diagnosis of neurogenic bladder in children with myelodysplasia]. / Elektrofiziologicheskaia diagnostika neirogennogo mochevogo puzyria u detei c mielodisplaziei.

Ninety-seven children with neurogenic bladder and myelodysplasia were subjected to complex examination. The somatic innervation of the sphincter urethrae externus and sphincter ani muscles was appraised by the method of sacral guided reactions by a CT-01 electromyograph and by an original method consisting in registration of the reflex response of the named anatomical structures according to the fluctuations of the intraurethral and intraanal pressure. It was established that maintained, partly disturbed, and absolutely absent somatic innervation of the sphincters of the bladder and rectum is encountered in patients with myelodysplasia. The more the innervation of the sphincters disturbed is, the more the urinary bladder is excluded from the "accumulation-evacuation" urodynamic cycle and the lesser the probability of disorders of urodynamics of the upper urinary tract is, and vice versa. The obtained information is important in choosing the therapeutic tactics for patients with a neurogenic bladder.

[Plastic repair of the isolated bladder in exstrophy in children]. / Plastika izolirovannogo mochevogo puzyria pri ego ékstrofii u detei.

Sigmoid colon segment was used to pass the urine through the intestine in 14 children with exstrophy of the bladder. Preoperative management of large intestine helped to reduce the number of operative stages from two to one. 12 patients were followed up from 1 to 3 yrs. Right ureterohydronephrosis of the upper urinary tract was observed in 1 patient. Urodynamic investigation of isolated sigmoid colon segment evidenced of its adequate contractile and peristaltic activity preventing the contact of feces with entero-ureteral anastomoses. To improve the closing ability of rectal sphincter in the above patients anal electrostimulation with diadynamic current can be recommended.

[The urodynamics of the lower urinary tract after reconstructive operations in bladder exstrophy]. / Urodinamika nizhnikh mochevykh putei posle rekonstruktivnykh operatsii pri ékstrofii mochevogo puzyria.

The results of plastics of the bladder with local tissues in its exstrophy in 34 children were appraised according to the findings of clinical, functional, and morphological studies. The cosmetic effect was satisfactory in 22 patients, but control over urination remained unsuccessful as a rule. Enuresis after sphincteroplasty was linked with functional insufficiency of the trigonal muscle due to tissue dysembryogenesis. Another component of enuresis was dysfunction of the bladder attended by intravesical hypertension and uninhibited contractions when its size was small. The results of morphological studies allowed the authors to explain the character of the urodynamic disorders and the inefficacy of their nonoperative correction.

[The role of estrogens in the pathogenesis of bladder dysfunction of the hyperreflexia type and vesico-ureteral reflux in children]. / Rol' éstrogenov v patogeneze neirogennoi disfunktsii mochevogo puzyria giperreflektornogo tipa i puzyrno-mochetochnikovogo refliuksa u detei.

Patients with the uninhibited urinary bladder of the hyperreflexia type and the vesicoureteral reflux were subjected to multimodality examinations which included excretory urography, retrograde cystometry, cystography, profilometry of the ureterovesical anastomosis, cytologic investigation of estrogenic saturation, determination of the concentration of follicle-stimulating hormone of the pituitary and estradiol by means of radioimmunoassay. As many as 56 girls aged 4 to 15 years underwent examination. It has been demonstrated that dysfunction of the urinary bladder of the hyperreflexia type is of crucial role as an active mechanism of extra-vesicalization of the intra-vesical part of the ureter, associated with its antireflux function distress.

[Renal artery aneurysms in children]. / Anevrizmy pochechnykh arterii u detei.

Renal artery aneurysms were diagnosed in 11 patients (9 boys) aged 1 to 14. The examinations were carried out for vasorenal hypertension in 4 cases, for bladder-ureter reflux, hematuria, nephroptosis in 4, ureterohydronephrosis in 2 cases, and for interstitial nephritis. Aneurysms of the major trunk of the renal artery, mostly oval-shaped, 11 x 14 to 25 x 28 mm in size, were detected in 4 patients, intrarenal aneurysms 2 x 3 to 5 x 6 mm in size in 7 cases. The share of aneurysms among uronephrologic conditions in children was found to be 1.54%, among vasorenal hypertension cases, 4.3%. Vasorenal hypertension is the main optional sign of aneurysms of the main trunk of the renal artery, whereas for intrarenal aneurysms such sign is hematuria.