Endoscopic correction of vesico-ureteral reflux in children: differentiated choice of method, material and its dosage

Introduction. The trend of modern medicine in the last decade is the increasingly frequent priority of minimally invasive technologies and the maximum possible delay of extensive surgical interventions according to indications, which is especially important in pediatric urological practice. Materials and methods. The presented work is devoted to the analysis of the compositions, effects and aftereffects when using various gel implants for vesico-ureteral reflux (VUR) correction. In total, 19 Russian, 30 foreign scientific publications and 3 Orders of the Ministry of Health of Russia were selected for publication. The isolated properties of polymeric materials, their predicted behavior in vitro under various external conditions, after implantation into biological tissues, as well as clinical data obtained by practicing specialists in the field of pediatric urology, were evaluated. Results. Various volume-forming gels have been used for endoscopic correction of VUR in children for 40 years, however, a number of questions regarding the choice ofthe protocol for primary endoscopic treatment and correction are currently open. The first step in the treatment of VUR remains with endoscopic correction (EC), while the second step is ureteral reimplantation. Although the EC technique is mature, a deeper study of previously known polymers and the emergence of new bulking agents (BA) based on various substances are gradually leading to a rethinking of approaches to the choice of BA. Inert and biocompatible polyacrylamide gel ofthe 3rd generation Refluxin has shown its stable efficacy and safety in the immediate period after implantation at different degrees of VUR in 1 year of clinical use. Conclusions. The developments and advances in modern approaches to the treatment of VUR in the future promise to standardize the choice of EC technique and help build an algorithm for determining the optimal tactics for endoscopic reflux correction using the entire spectrum of volume-forming agents.