Aim. To optimize conservative and surgical treatment of neuromuscular dysplasia of the vesicoureteral segment in children.Materials and methods. Study included 84 operated children with neuromuscular dysplasia of the vesicoureteral segment of the ureters. Megaureter antenatally diagnosed in 28 (25.4%) children: Ι degree - in 5, II degree - in 9, III degree - in 10, IV degree - in 4 children. The main criteria for diagnosing a megaureter in the perinatal period are an expansion of the anterior-posterior size of the pelvis, visualization of the dilated ureter, and in СFM - identification of weakening of the renal blood flow in the affected side.Results and discussion. As a result of the conservative and minimally invasive therapy – stenting of the ureters for up to 2 years, urodynamics were restored and the phenomena of ureterohydronephrosis were eliminated in 30 (27.2%) patients. In 32 (29%) patients, percutaneous puncture nephrostomy was performed, aimed at reducing the collecting system of the kidney, and ureter, as well as preparing for surgical treatment. The operated patients (84) were divided into 3 groups: Group I - operated according to the Politano-Ledbetter method (29); Group II - according to Cohen (20); Group III operated according to the method of extravesical reimplantation of the ureter with antireflux protection, developed in the clinic of pediatric surgery (35). Complications were noted in 8 (27.5%) patients after the Politano-Ledbetter operation; in 4 (20%) cases after the Cohen method operation; and in 5 (14.2%) cases after the extravesical reimplantation with antireflux protection.Conclusion. The method of ureteral reimplantation, developed and tested at the Clinic of Pediatric Surgery, is a fairly effective way to treat megareteral disease in children. This technique is highly effective in children older than 1-3 years, which makes 85.8%.

Objective: To optimize the technique of extravesical ureteral reimplantation in experimental animals. Methods: Experiments were carried out on 21 Flanders rabbits. Initially, ureterohydronephrosis (UHN) was modeled by alcoholization of the ureter in its vesical part according to the method of Ya.V. Gudynsky. After 21 days, the animals underwent extravesical ureteral reimplantation using the technique optimized by the team of urologists. Results: The stents were removed endoscopically on the 20th day. In order to exclude vesicoureteral reflux, contrast cystography was performed, in which reflux was not detected. To exclude obstruction, on the 30th, 60th, and 90th days after the operation, an ultrasound scanning of the urinary system was performed, in which the presence of UHN was not noted. On the 90th day, the experimental animals underwent resection of the anastomotic zone for histological examination. It was found that the diameter of the transplanted segment corresponded to the normal size of the rabbit ureter, there was a slight thickening of the ureteric wall, its hypertrophy, and intracellular hyperplasia. Conclusion: The effectiveness and safety of the proposed method of extravesical ureteral reimplantation with antireflux protection has been experimentally proven. Keywords: Ureter, urodynamics, obstruction, ureterohydronephrosis, megaureter.