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The endoscopic treatment of vesicoureteral reflux in children
Russian Federation (HCCM Russia) - Samara State Medical University, Samara
The department of children surgery
Dr. Margarita Al. Barskaya
Dr. Gasanov Dzhalil Amrovich
Type of Research Project
- Clinical Project with Laboratory work
What is the background of the project?
Since 1981 the endoscopic treatment of vesicoureteral reflux (VUR) has been performed via synthetic prosthetic implants. Despite the variety of urological implants, currently there’s no “gold standard” in choosing one of them. The development of obstructive megaureter (OM) in some children in the postoperative period has become an actual problem of using the persistent volume-forming substances, such as Vantris, Urodex. The reasonable selection of patients via the original technique has reduced the risk of obstructive complications to 0%.
What is the aim of the project?
The developing methods to prevent obstructive complications after using the volume-forming persistent substances at endoscopic treatment of VUR in children.
What techniques and methods are used?
The ultrasound examination of kidneys and bladder; voiding cystourethrography; excretory urography; scintigraphy; cystoscopy; histological examination. All procedures from above will give us a data, such as level and velocity of vesico-urethral reflux, the variations of anatomical structure of locking system between the ureter and the bladder, which give us that info that will allow to make a conclusion about the severity of VUR and to understand the best way to treat it right.
What is the role of the student?
- The student will observe the practical experiments but will be highly involved in the analysis of the results
- The tasks will be done under supervision
What are the tasks expected to be accomplished by the student?
The student will be able: to obtain and analyze the data of positive and negative aspects of using different methods of elimintaion VUR. For example rate of recurrence, the structure and amout of complications after different surgeries; to make conclusions about the preferences of one or another method based on obtained data to help during diagnostic and treatment procedures, such as ultrasound, cystography and so on, and assisting on surgeries.
Will there be any theoretical teaching provided (preliminary readings, lectures, courses, seminars etc)
Lectures and seminars uppon arrival by Dr. Gasanov about anatomy, physiology urinary system, general methods of VUR elimination, especially the ones that include using of bulk forming materials.
What is expected from the student at the end of the research exchange? What will be the general outcome of the student?
- The student will prepare a presentation - The student will prepare a scientific report - The student’s name will be mentioned in a future publication
What skills are required of the student? Is there any special knowledge or a certain level of studies needed?
To understand a anatomy and physiology of urinary system, pathological physiology of visicoureteral reflux ; to know how to perform the catheterization of the bladder and how to set a cystourethroscope during the cystoscopy. Subjects passed: General Surgery, Children Surgery.
Are there any legal limitations in the student’s involvement
All manipulations must be done under tutor’s supervision.
Type of students accepted
This project accepts: - Medical students - Graduated students (less than 6 months)
- Vandersteen DR; Routh JC; Kirsch AJ; Scherz HC; Ritchey ML; Shapiro E; et al. Postoperative ureteral obstruction after subu-reteral injection of dextranomer/hyaluronic Acid copolymer. J Urol 2006;176(4 Pt 1):1593-5
- Kirsch AJ; Perez-Brayfield M; Smith EA; et al. The modified STING procedure to correct vesicoureteral reflux: improved results with submucosal implantation within the intramural ureter. J Urol 2004;171:2413–6
- Cerwinka WH; Scherz HC; Kirsch AJ. Dynamic hydrodistention classification of the ureter and the double HIT method to correct vesicoureteral reflux. Arch Esp Urol. 2008 Oct;61(8):882-7
- Chertin B; Arafeh WA; Zeldin A; Ostrovsky IA; Kocherov S. Endoscopic correction of VUR using vantris as a new non-biodegradable tissue augmenting substance: three years of prospective follow-up. Urology. 2013 Jul;82(1):201-4
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