[The conservative treatment of children with vesico-ureteral reflux].

The article deals with the results of examination and nonoperative treatment of 120 children with vesicoureteral reflux (VUR). Their ages ranged from 3 to 13 years. The authors used a complex of methods for the examination of the functional condition of the kidneys, upper urinary tract (excretory urography, renoscintigraphy, electroureterography, clearance tests), lower urinary tract (cystography, cystoscopy, cystotonometry, urethroprofilometry, electromyography of the detrusor and its obturator apparatus), bacterio- and immunological studies (determination of the microbial number, bacteria covered with antibodies, immunoglobulins G, A, and M). The results of the study were analysed in 3 groups in which VUR was linked with normoreflexia (33.3%, group 1), hyperreflexia (48.6%, group 2), and hyporeflexia (18.1%, group 3). There was an obvious growth of cystitis incidence in patients with bladder dysfunction. The data of computed scintigraphy showed partial renal dysfunction in patients with unilateral VUR not only on the side of the affection but also in the contralateral intact kidney. It is assumed that there is a clear relation between the degree of renal dysfunction, the ureteral motor activity, and bladder dysfunction. The treatment included: (1) pharmacotherapy of neurogenous bladder dysfunction with belladonna preparations (in hyperreflex) and aceclidine (in hyporeflex urinary bladder) in optimization of the organism's bioenergetic processes; (2) percutaneous bladder electrostimulation; (3) combination of the listed methods together with cerucal. The results of treatment and the indications (absolute and relative) for nonoperative treatment of VUR in children are discussed.