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Dysfunction of the pelvic organs in children with myelodysplasia is a complex multifaceted problem. In some patients with long-term vesicoureteral reflux, as a complication of neurogenic bladder dysfunction, reflux nephropathy (RN) develops in a chronic kidney disease (CKD) outcome. One of the most effective as well as minimally invasive surgical interventions in this case is chemodenervation of the detrusor with botulinum toxin. This intervention in most cases not only improves the quality of life of patients, but also prevents further development of RN helping children to avoid traumatic augmentation surgery in the future. However, the duration of the chemodenervation effect is often insufficient. In the Authors’ opinion, synergistic conservative therapy aimed at improving regional blood circulation and correcting energy deficit is a must in order to improve the results. The result of the synergy of surgical and conservative treatment and their effectiveness are described in the presented clinical case observation.

Urinary tract infection (UTI) and chronic pyelonephritis, in particular, are a serious medical and social problem. Late diagnosis and improper treatment of this pathology lead to serious consequences for the health of children. Frequent relapses, a wide variety of pathogens, lack of verbal contact with young children, and much more make the diagnosis and treatment of UTIs a complex and multifaceted task. Due to frequent relapses, diagnostic defects and incorrect treatment tactics can lead to decreased kidney function and chronic kidney disease. In the context of the COVID-19 pandemic, the attention of doctors to chronic pathologies is reduced, which can undoubtedly lead to a deterioration in the quality of the diagnostic and treatment process. However, despite the importance of fighting the pandemic, the decline in the quality of medical care for other categories of patients is unacceptable. It is known that intercurrent diseases, including viral infections, often lead to exacerbations of chronic forms of UTI, and the role of COVID-19 in this is an important issue that requires careful study. In this regard, we decided to present a clinical case of an exacerbation of chronic pyelonephritis and difficulties in treating a child with a neurogenic bladder against the background of COVID-19.