Репозиторий Университета

© 2019, Pediatria Ltd. All rights reserved. Pyelonephritis treatment in children with neurogenic bladder (NB) has a number of peculiarities, which include incomplete bladder emptying after self-urination and causing difficulties in determining treatment tactics for primary care pediatricians. Residual urine is a risk factor for development and relapse of chronic pyelonephritis, and urinary incontinence is also a medical and social problem. The article presents an example of observing an 8-year-old girl after 2 years of ineffective treatment for chronic pyelonephritis with mistakes in primary diagnosis. It provides the analysis of 3 months treatment and examination of the child with NB, including monitoring of urination functional productivity. The scheme of combined correction of inflammatory process and urinary tract dysfunction is presented. A systematic step-by-step approach to diagnosis and treatment of recurrent pyelonephritis in children with NB allows to increase therapy efficacy and improve patient's quality of life. The presented clinical case differs because bladder dysfunction manifested itself at the age of 8 years with an increase of bladder residual volume. Peculiarity of pathogenetic mechanisms of this pathology development in the described observation is a combination of delayed mature urination formation and manifestation of acute pyelonephritis, which required a non-standard approach to diagnosis and treatment.