Introduction. Recently, the prevalence of urolithiasis in pediatric population has been steadily increasing, but up to now there is no any universal technique for treating urolithiasis in children. Among many options for surgical treatment of upper urinary tract urolithiasis, remote lithotripsy occupies one of the leading positions.Purpose. To highlight principles and mechanisms of remote lithotripsy, its indications and contraindications using a systemic review of modern literature for the period of 2001–2021.Material and methods. A systematic review of foreign and domestic literature for the period of 2001–2021 was made. Key words for the search were : urinary stone disease, urolithiasis, remote (shock wave) nephrolithotripsy, fragmentation of stones. 64 full-text articles out of 1339 literature sources are included in the review.Results. On analyzing the obtained results, it has been found out that one session of remote shock wave lithotripsy is effective in more than 90% of cases, if calculus dimensions are less than 20 mm and its density is less than 1200–1500 Hounsfield units. Location of the calculus also plays a role.Conclusion. Remote shock wave lithotripsy is a reasonable option due to a number of facts, the main of which are non-invasive approach and a large percentage of favorable outcomes associated with cleaning the upper urinary tract from stones.

Predicting the outcome of endoscopic correction of vesicoureteral reflux (VUR) is an urgent problem in pediatric urology because the identification of predictors for the effectiveness of endoscopic treatment of VUR will optimize the strategy for examination and treatment of the disease. The purpose of the research was to evaluate the statistical impact of various predictors on the success of endoscopic correction of VUR; to predict the clinical outcome by creating a mathematical model. Materials and methods used: a single-center experimental uncontrolled study was conducted in Sept. 2017 - Feb. 2022. The results of treatment of 150 pediatric patients (240 renal units) aged from 1 month till 7 years old who underwent endoscopic correction of VUR are presented. The following indicators were evaluated as predictors: gender, age of the disease manifestation, bilateral/unilateral VUR, grade of VUR, ureteral diameter ratio (UDR), cystography initial confirmation of VUR, expansion of the pelvicalyceal system and ureter according to ultrasound, the presence of urinary tract infection. Results: according to the data obtained, when comparing the grade of VUR, cystography initial confirmation of VUR, UDR, expansion of the pelvis and ureter depending on the result of treatment, the statistically significant differences have been found (p<0.001). A prognostic model has been developed to determine the probability of the outcome of endoscopic correction of VUR using the binary logistic regression method. The area under the ROC curve was 0.985±0.007 with 95% CI: 0.967-1.000. The resulting regression model was statistically significant (p<0.001). The sensitivity and specificity of the model were 96.4% and 95.3%, respectively. Conclusion: the results of the research show that UDR and the initial confirmation of VUR have greater predictive power for the success of the endoscopic urethroplasty compared to the grade of VUR alone. The use of the predictors and predictive modeling can help improving the selection of candidates for the endoscopic correction of VUR and developing personalized treatment tactics.

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The article presents a modern view on the prognostic factors of spontaneous resolution and effectiveness of treatment of children with vesicoureteral reflux (VUR). The most frequently used predictors of successful treatment of VUR (grades of reflux, distal ureteral diameter ratio to the distance of the lumbar vertebrae, reflux induction phase on mictional cystourthrography), delayed removal of contrast from the upper urinary tract, gender, age, antenatal hydronephrosis). Methodology, statistical significance, advantages, disadvantages of the described prognostic factors are analyzed.

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