This article discusses the issues of medical rehabilitation of children with megaureter with concomitant neurogenic bladder dysfunction. Objective of the study: scientific substantiation of the use of selective chromotherapy in medical rehabilitation of children with megaureter with concomitant neurogenic bladder dysfunction. Materials and research methods: clinical observations and special studies were carried out in dynamics in 40 children, aged 1 to 7, with megaureter after ureteral surgery. Of these, 20 children made up the main group (received selective chromotherapy, blue spectrum); 20 children — the control group (without physiotherapy). Based on the studies carried out, a beneficial effect of medical rehabilitation with the inclusion of selective chromotherapy in children with megaureter and concomitant neurogenic bladder dysfunction was revealed. The inclusion of selective chromotherapy in the program of medical rehabilitation of children with megaureter contributed to a decrease in the activity of inflammation in the renal parenchyma (decrease in proteinuria, leukocyturia). Selective chromotherapy had a positive effect on the urodynamics of the lower urinary tract (reduction in the number of urgent urges and episodes of urinary incontinence, decreased frequency of urination, improved uroflowmetry indicators). The effectiveness of medical rehabilitation with the inclusion of selective chromotherapy was 80.0 %, while in the control group — 40.0 %.

To analyze the clinical cases of four patients with grade IV bilateral hydronephrosis. Ultrasound examination of the urinary system was used as the main examination method. During the first stage of surgical treatment, all children underwent preliminary urinary diversion; a month later, the results were assessed. The result of the preliminary urinary diversion was the implementation of the Heines-Andersen-Kucher reconstructive operation. According to the control ultrasound performed a month after the nephrostomy, pelvis on the nephrostomy was reduced in all cases, parenchyma thickness increased by an average of 4.5 times, improvement in intragranular blood flow was noted. Evaluation of the effectiveness of pyeloplasty was carried out according to three criteria: restoration of urodynamics, restoration of kidney function and the presence of infectious complications. The parenchyma of the operated kidney grew by an average of 3 times, the pelvis decreased by an average of 3.5 times. Restoration of intrarenal blood flow to the cortical layer, inclusive, was noted in 5 of 8 renal units. Before pyeloplasty, there were marked changes in the renal parenchyma and a decrease in its function by an average of 34 14 %; a year after reconstructive surgery, the changes became moderate, there was an improvement in renal function, a decrease in function by 25 10 %. In our opinion, the starting method for providing urgent surgical care to neonates and breastfed infants with grade IV GN is preliminary urinary diversion, which allows us to determine the functional reserve of the renal parenchyma, delay reconstructive surgery, thereby giving time for the restoration of renal function and avoiding organ-carrying surgery.

A review of the domestic and foreign scientific literature is devoted to an actual problem of pediatrics — congenital hydronephrosis, the cause of which is an aberrant vessel. The features of the diagnosis of the vessel and methods of surgical treatment are considered. The technique and indications for non-dismembered pyeloplasty “vascular hitch” are analyzed in detail.

Biopsies of removed spina bifida and regional tissue in 21 children (before the age of 1 year) who were operated on meningoradiculocele and 18 biopsies in combination with congenital intradural malformations were exposed to morphological study. Retrospective analysis of histological features of the various forms of spina bifida identified an objective assessment of expediency of different methods of surgical treatment according to the form of malformation. The results showed that skin covering the area of all forms of spina bifida is characterized by distinct polymorphism. At the same time the specific changes of epidermis were not found in the various forms of spina bifida. The often result of operations, which were conducted outside of a specialized agency, is aggravation of the disintegration and demyelization processes caused by secondary arachnoid, soft and dura mater adhesions, greater involvement of the spinal cord pathways and roots in the adhesions, severe disorders of local hemodynamics.

Myelodysplastic syndrome is an abnormal development of the spinal cord, spine and axonal pattern with hidden and obvious clinical signs, concurrent disturbances of the functions of the locomotor system, pelvic organs, etc. Polymorphy of clinical dysembriologic signs hampers development of the single strategy for diagnostic and therapeutic activities which makes the issue constantly pressing.

Disorders of pelvic organs' evacuation function, manifested by difficulty in urination and constipation, in conjunction with incontinence, and childhood stool smearing is an urgent medical and social problem. The study presents results of treatment of 36 children (mean age 7,2 +/- 2,3 years) with non-neurogenic variants of pelvic organ dysfunction. The choice of treatment was based on an attempt to form managed urination. Indications to treatment were defined both by traditional methods, and by transperineal ultrasonography - the method developed by the authors. Increased rear urethrovesical angle at rest and during functional tests with retention and straining, the deviation of the bladder neck and urethra to sacrum, shortening of urethra and bladder neck, lack of bladder neck and urethra movement, or the inability to perform volitional exercises were seen as signs of pelvic floor paradoxical movements. Analysis of the results of clinical trials showed, that the method is a reliable, non-invasive and does not require expert class ultrasound equipment. The treatment consisted of biofeedback therapy sessions performed in outpatient settings. 25 children were found to have positive changes, 7 of them fully recovered from voiding dysfunction.

Urologic malformations are the most wide spread pathologythat are founded in 5-14% of newborns. Thefrequencyis 6—8 casesin 1000 newborns. Among all prenatally detected defects, the kidneys and urinary system malformations is 26 to 28%.The prenatal consulting center was formed in the Filatov’s Children Hospital. The postnatal management protocol for children with urologic malformations identified prenatally was set up.The results of treatment more than 1500 patients allow recommendingthree-stage management for children with obstructive uropathy. The introduction in the perinatal urology and empowers outpatient medical record technology, allow to obtain good results of treatment and reduce the number of organ removal procedures.

37 children (60 ureters) in the age from 3 days to 3 months with primary vesioureteral reflux (VUR) were threated in the Newborn surgery department of the Filatov’s Children Hospital since January 2007 till December 2011. The diagnosis was proved by the retrograde urethrography. The endoscopic fixing of the ureteral orifice by collagen performed in children with the primary VUR, complicated by infectious events or by reflux nephropathy. After hospitalization all children were under the care and treatment for prevention of infection and chronic kidney disease. The duration of the follow-up was from 1 to 4 years. The analysis of the long-term results shows that the usage of endoscopic treatment of the primary VUR in newborns and infants allows to restore the urinary tract urodynamics, to decrease the number of infectious complications, to prevent the progression of severe complications such as chronic kidney disease.