Makedonsky I. Surgical treatment and medical abilitation of children with anorectal malformations and bladder exstrophy (experimental-clinical investigation)

An object - congenital anorectal malformations and bladder exstrophy in children; aim - to improve the results of treatment of children with anorectal malformations and bladder exstrophy by development and introduction a new program of аbilitation, based on improvement of prenatal diagnostics, early detection of neurogenic voiding dysfunctions, optimisation of surgical technics, which decreases risks of urogenital organs damage, use of biofeedback methods of medical abilitation, research of quality of life and cost of treatments; methods - experimental, clinical, ultrasonic, urodynamical, clinical-instrumental, morphological, morphometrical, immunohistochemical, radioimmunological, hormonal researches and statistics; novelty - a dissertation is containing a new direction in the decision of problem of improvement of diagnostic system and improvement of treatment results of children with the combined anorectal malformations and bladder exstrophy by creation, scientific ground and clinical introduction of new scheme of abilitation; results - proposed algorithms improve accuracy of anorectal defects detection up to 40 %, and bladder exstrophy - to 33,3 %, created methods of bladder exstrophy correction improves the percent of good long term treatment results with 39,4% to 86,6%, рrogram of abilitation allowed to improve quality of life indexes on 22,9%, decrease the treatment costs of patients with anorectal malformations on 36,9%, with bladder exstrophy - on 48%; introduced - in the therapeutic and educational process; industry - medicine.