[Neuromuscular dysplasia of the ureters in children]

The paper is concerned with disputable aspects of the policy in the diagnosis of neuromuscular ureteral dysplasia (NUD) in children, with indications to NUD conservative treatment and a choice of optimal surgical correction at primary or repeat operations basing on ureteral dilatation. The necessity of the NUD conservative treatment in children with nonaffected renal function has been confirmed by 52 cases of NUD children treated conservatively or surgically. The analysis of surgical outcomes in 34 NUD children and urodynamic pre- and postoperative examinations in 18 of them suggest the following conclusions: 1) the decision on "modelling" of the ureter is feasible only in the course of surgical intervention; 2) in ureteral dilatation less than 5-7 mm "modelling" is unnecessary. In other cases "modelling" is made at primary surgery according to Kalicinski's technique, at resurgery according to Hander. Positive outcomes in primary interventions were registered in 78% of the patients, 62% of the operations were successful in recurrent disease.