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Introduction. Nephrectomy (NE), heminephrectomy (HNE) and the formation of ipsilateral ureteroureteroanastomosis (UUA) do not exclude the possibility of preserving the distal ureter. The remaining ureteral stump can cause the formation of ureteral stump syndrome (USS) in the form of recurrent urinary tract infection (UTI), hematuria, pain syndrome, and stump empyema in some cases.Purpose of the study. To assess the incidence and treatment approach of USS in children after NE, HNE and UUA performed using open and laparoscopic access in different Russian clinics.Material and methods. The study is based on the results of treatment of 778 patients from 9 clinics in the Russian Federation and the Republic of Belarus in the period from 1998 to 2020. Patients underwent NE, HNE and UUA by open or laparoscopic access. The ureter was not removed completely, its stump was left. Open access was used in 313 (40.2%) children, laparoscopic in 465 (59.8%) cases. USS was detected in 27 (3.5%) patients. The ureteral stump was removed in 26 (96.3%) children. Open removal of the ureteral stump was performed in 11 (42.3%) patients, through laparoscopic access in 13 (50.0%) and vesicoscopically in 2 (7.7%) children.Results. There were 12 boys (44.4%) and 15 girls (55.6%) among the patients with USS. USS was detected on the right in 13 (48.1%) children, on the left - in 14 (51.9%). The median age of the patients was 25 [12; 42] months at the time of USS detection. Ureteral stump was sutured and ligated in 15 (55.6%) children during the primary operation, the stump was left open after excision in 4 (14.8%) children, it was not indicated how the stump was processed in 8 (29.6%) patients. Reflux to the stump was detected in 13 (48.1%) patients, USS against the background of obstruction was detected in 14 (51.9%) children. It was determined that the frequency of SCM is lower (9 (1.9%)) with the use of laparoscopic access than with open (18 (5.8%)) operations (p < 0.004). Clinical manifestations occurred in 85% of patients with USS within a year after surgery.Conclusion. USS is a rare complication (3.5% of cases) in patients who have undergone NE, HNE and UUA with the distal ureteric stump preserving. Performing these operations by laparoscopic access allows carrying out total ureterectomy and significantly reduces the likelihood of USS development.

Almost all surgical repair techniques for hypospadias include dissection of the glans penis, and covering the neo-urethra with the glans tissue circumferentially. Surprisingly, the presence of the "septum glandis" in the ventral midline has been overlooked for decades. A careful examination of six patients with iatrogenic hypospadias (IH) revealed direct indications of the septum glandis. All patients were

BACKGROUND: The relevance of destructive pyelonephritis in pediatric practice is determined by frequency of various complications of the disease associated with a high risk of irreversible morphofunctional changes in parenchyma of affected kidney, the lack of tactical consensus in the professional community and regulatory documents regulating the procedure for diagnostic and therapeutic support of this contingent of patients. AIM: Substantiation of the tactics of effective treatment children with destructive pyelonephritis, based on the results of a multifactorial retrospective analysis of the course and outcomes of the disease. MATERIALS AND METHODS: The results of the analysis of medical documentation of 38 patients with destructive pyelonephritis aged 3204 months (median 93.5) who received inpatient treatment in 20152019 in three specialized clinics in Moscow are presented. RESULTS: More than half of the patients (28 children) in the acute period of the disease received conservative therapy, including infusion and antibacterial, the escalation of which was carried out with the preservation or increase of manifestations of the systemic inflammatory response syndrome, as well as negative dynamics according to ultrasound or CT data. In the group of patients (n = 10), indications for surgical treatment were formulated decapsulation of the kidney, opening of apostemas and abscessed foci, drainage of the paranephral space. During the examination in catamnesis, realized in 50%. It was found that in the majority (91%) of children treated conservatively, a statistically significant decrease in the volume of the kidney on the affected side was registered. These complications were not detected among the operated patients. CONCLUSION: The pharmacy of choice for starting antibacterial therapy should be inhibitor-protected beta-lactams, carbapenems, if the etiological significance of staphylococcus is suspected, it is advisable to connect linezolid. In case of laboratory signs of hypercoagulation, it is necessary to connect anticoagulants. Surgical tactics can minimize the risk of complications associated with the purulent-destructive process, contributing to regenerative processes in the kidney parenchyma. The objectification of the results of the catamnestic examination is due to the performance of nephroscintigraphy.