urovestВестник урологииUrology Herald2308-6424Rostov State Medical University10.21886/2308-6424-2021-9-4-133-141urovest-510Research ArticleКЛИНИЧЕСКИЕ НАБЛЮДЕНИЯCLINICAL CASESЭкстравезикальная реимплантация внепузырно-эктопированного мочеточника верхней половины удвоенной почкиExtravesical reimplantation of an extravesical-ectopic ureter from the upper pole of a duplicated kidneyhttps://orcid.org/0000-0003-4895-7533МакаровГ. А.MakarovG. A.

Макаров Геннадий Анатольевич — детский уролог-андролог детского уроандрологического отделения ОКДБ.

344015, Ростов-на-Дону, ул. 339-й Стрелковой дивизии, д. 14.

Gennadiy A. Makarov — M. D., Pediatric Urologist and Andrologist, Pediatric Urology and Andrology Division, Rostov Regional Children's Clinical Hospital.

344015, Rostov-on-Don, 14 339th Strelkovoy Divisii St.

g.a.makarov@yandex.ruhttps://orcid.org/0000-0001-9145-8671СизоновВ. В.SizonovV. V.

Сизонов Владимир Валентинович — доктор медицинских наук, доцент; заведующий детским уроандрологическим отделением ОКДБ; профессор кафедры урологии и репродуктивного здоровья человека (с курсом детской урологии-андрологии) РостГМУ Минздрава России.

344015, Ростов-на-Дону, ул. 339-й Стрелковой дивизии, д. 14; 344022, Ростов-на-Дону, пер. Нахичеванский, д. 29.

Vladimir V. Sizonov — M. D., Dr.Sc. (Med), Assoc.Prof. (Docent); Prof., Dept. of Urology and Human Reproductive Health (with Pediatric Urology and Andrology Course), Rostov State Medical University; Head, Pediatric Urology and Andrology Division, Rostov-on-Don Regional Children's Clinical Hospital.

344015, Rostov-on-Don, 14 339th Strelkovoy Divisii St.; 344022, Rostov-on-Don, 29 Nakhichevanskiy Ln.

vsizonov@mail.ruhttps://orcid.org/0000-0003-0706-5723ОрловВ. М.OrlovV. M.

Орлов Владимир Михайлович — кандидат медицинских наук, детский уролог-андролог детского уроандрологического отделения ОКДБ.

344015, Ростов-на-Дону, ул. 339-й Стрелковой дивизии, д. 14.

Vladimir M. Orlov — M. D., Cand.Sc. (Med); Pediatric Urologist and Andrologist, Pediatric Urology and Andrology Division, Rostov Regional Children's Clinical Hospital.

344015, Rostov-on-Don, 14 339th Strelkovoy Divisii St.

diggyboo@bk.ruhttps://orcid.org/0000-0003-4177-6772ВигераВ. В.VigeraV. V.

Вигера Владимир Васильевич — ординатор кафедры урологии и репродуктивного здоровья человека (с курсом детской урологии-андрологии) РостГМУ Минздрава России.

344022, Ростов-на-Дону, пер. Нахичеванский, д. 29.

Vladimir V. Vigera — Resident, Dept. of Urology and Human Reproductive Health (with Pediatric Urology and Andrology Course), Rostov State Medical University.

344022, Rostov-on-Don, 29 Nakhichevanskiy Ln.

vigeravladimir@yandex.ruОбластная детская клиническая больницаРоссияRostov-on-Don Regional Children's Clinical HospitalRussian FederationОбластная детская клиническая больница; Ростовский государственный медицинский университет Минздрава РоссииРоссияRostov-on-Don Regional Children's Clinical Hospital; Rostov State Medical UniversityRussian FederationРостовский государственный медицинский университет Минздрава РоссииРоссияRostov State Medical UniversityRussian Federation20212412202194133141Copyright © Макаров Г.А., Сизонов В.В., Орлов В.М., Вигера В.В., 20212021Макаров Г.А., Сизонов В.В., Орлов В.М., Вигера В.В.Makarov G.A., Sizonov V.V., Orlov V.M., Vigera V.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.urovest.ru/jour/article/view/510

Внепузырная эктопия мочеточника является редкой причиной недержания мочи. Мы сообщаем о трёхлетней девочке с недержанием мочи. Девочка наблюдалась и лечилась по поводу рецидивирущей инфекции мочевых путей (ИМП) на фоне удвоения верхних мочевых путей слева и пузырно-мочеточниковых рефлюксов (ПМР). Двукратное эндоскопическое лечение ПМР с помощью декстраномера гиалуроновой кислоты позволило устранить их с двух сторон, добиться стойкой клинико-лабораторной ремиссии ИМП. У ребёнка после приучения к горшку появилось постоянное капельное выделение мочи на фоне нормальных мочеиспусканий. Выявлены внепузырная эктопия устья мочеточника верхней половины левой почки и объёмное образование мочевого пузыря с гиперденсивными включениями в проекции треугольника Льето слева, расценённое как результат миграции импланта и его изменений. Наличие объёмного образования определило выбор методики хирургии в пользу формирования уретероцистоанастомоза с эктопированным мочеточником верхней половины удвоенной почки и удаления объёмного образования мочевого пузыря. При ведении пациентов после эндоскопического лечения ПМР следует учитывать возможность изменений болюса с накоплением в нем солей кальция и мочевой кислоты.

Extravesical ureter ectopia is a rare cause of urinary incontinence. We are reporting a case of a 3-year-old girl with urinary incontinence. The girl was observed and treated for recurrent urinary tract infection (UTI) against the background of left-side duplication of the upper urinary tract and vesicoureteral reflux (VUR). Two-time endoscopic treatment using a dextranomer/hyaluronic acid allowed to eliminate VUR on both sides and achieve stable clinical and laboratory remission of UTI. After potty training, the child had a constant drip of urine along with normal urination. The examination revealed extravesical ureter ectopia of the left duplicated kidney upper pole and a bladder space-occupying mass with hyperdensive inclusions in the projection of the vesical trigone on the left, which we regarded as a result of the migration of the implant and the appearance of histopathological changes in it. The presence of a bladder space-occupying mass determined the choice of the surgical technique in favor of the formation of a ureterocystoanastomosis with a duplicated ectopic ureter and the removal of a bladder space-occupying mass. When managing patients after endoscopic treatment of VUR, it should be considered the possibility of morphological changes in the bulking agent due to the accumulation of calcium and uric acid salts.

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The authors declare that there are no conflicts of interest present.