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Published on: April 4, 2025
[Medical Rehabilitation after Hydronephrosis Surgical Treatment in Children]
I V Pogonchenkova1, M A Khan1, Ye V Novikova2
1Moscow Centre for Research and Practice in Medical Rehabilitation, Restorative and Sports Medicine, 105120, Moscow, Russia.
Insights
High-intensity pulsed electromagnetic field therapy significantly improves medical rehabilitation outcomes for children post-hydronephrosis surgery. This advanced therapy aids urinary tract function and reduces inflammation, leading to better recovery.
Area of Science:
- Pediatric Nephrology
- Medical Rehabilitation Technologies
- Urology
Background:
- Hydronephrosis in children necessitates effective medical rehabilitation post-surgery to prevent chronic kidney disease and disability.
- Post-ureter surgery, rehabilitation must address urodynamics and promote tissue regeneration.
- High-intensity pulsed electromagnetic field (HIPEF) therapy shows promise over traditional electrical stimulation for rehabilitation.
Purpose of the Study:
- To evaluate the efficacy of HIPEF therapy as part of medical rehabilitation for children after hydronephrosis surgery.
- To assess HIPEF's impact on urinary tract urodynamics, renal blood flow, and inflammation.
Main Methods:
- A clinical study involving 80 children (ages 3-15) operated for hydronephrosis.
- The main group (40 children) received HIPEF therapy alongside standard care (uroseptics, exercise therapy).
- The control group (40 children) received standard care only.
- Effectiveness was assessed via clinical, laboratory, ultrasound, and Doppler ultrasound of renal blood flow.
Main Results:
- HIPEF therapy demonstrated a positive effect on urinary tract urodynamics, reducing renal pelvis and calyx size.
- Restoration of renal blood flow, particularly to the renal cortex, was observed.
- Significant reduction in renal parenchyma inflammation, evidenced by decreased proteinuria and leukocyturia.
- Medical rehabilitation with HIPEF therapy achieved an 87.5% effectiveness rate.
Conclusions:
- HIPEF therapy is a rational and effective component of medical rehabilitation for pediatric hydronephrosis patients post-surgery.
- The therapy improves urodynamics, renal perfusion, and reduces inflammation, contributing to better patient outcomes.
- HIPEF therapy offers a superior approach to enhancing recovery and preventing long-term complications.
Abstract:
The article presents modern technologies of medical rehabilitation of children operated for hydronephrosis. The importance of medical rehabilitation of children with hydronephrosis is associated with high incidence, possibility of developing chronic kidney disease, and early disability of these patients. After surgery on the ureter it is important to use medical rehabilitation technologies aimed at preventing urodynamics disorders of upper and lower urinary tract, and at stimulation of regenerative processes. In recent years, particular attention has been paid to high-intensity pulsed electromagnetic field therapy, which has a more significant and long-term stimulating effect compared to various types of electrical stimulation. Clinical studies were conducted in 80 children operated for hydronephrosis, aged 3 to 15. The main group consisted of 40 children who received high-intensity pulsed magnetic therapy, and 40 children were included in the control group (without physiotherapy). Basic treatment included uroseptics and exercise therapy. Effectiveness of the method was assessed using clinical, laboratory and ultrasound data, and Doppler ultrasound of the renal blood flow. The results of the study demonstrated the rationale of including high-intensity pulsed electromagnetic field therapy in medical rehabilitation of children operated for hydronephrosis. The positive effect of high-intensity pulsed electromagnetic therapy on the urodynamics of the urinary tract (reduction in the size of renal pelvis and calyx) and renal blood flow (restoration of blood flow to the renal cortex) were revealed. This method helped to reduce inflammation in the renal parenchyma (reduction of proteinuria, leukocyturia) in children operated on for hydronephrosis. A significantly higher effectiveness of medical rehabilitation with the use of high-intensity pulsed magnetic therapy was proved (87.5%).
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