Long term follow up result of posterior urethral valve management.
Keywords:
Posterior urethral valve
Abstract
Introduction:Posterior urethral valve (PUV) is a commonest cause of urinary outflow obstruction leading to childhood renal failure, bladder dysfunction and somatic growth retardation. The incidence of PUV is 1 in 5000 to 8000 male birth. The objective and scope of present study is to compare the long term result posterior urethral valves that are managed by different techniques at our institute.Material and Methods:Study was carried out in S N Medical college Agra India. It is a retrospective study of the patients who were managed from 2007-17 and followed up in our department.Results:76% patients presented with urinary symptoms, 16.7% presented with septicemia and 6.3% presented with failure to thrive. Valve ablation was the primary mode of treatment in 23 patients, vesicostomy 5 patients and high diversion in 2 patients. Vesicoureteric reflux was present in 26 patients. According to IAP classification of growth and development 17 patients were normal 4 patients had PEM grade – I and 3 patients in each grade II, III and IV. 4 patients developed chronic renal failure and 3 patients had stage renal disease. Conclusion: Posterior urethral valve is a dynamic disease that can have life long effects on bladder. These patients need long term follow up care to monitor and treat the effects of altered bladder compliance.DOI: 10.21276/AAMS.1748References
1. D.F.M. Thomas and K.A.R. Hutton, Posterior urethral valves, Eur Urol Update Ser 3 (1994), pp. 34–39.
2. Hendren WH. Posterior urethral valves in boys: a broad clinical spectrum. J Urol 1981; 106: 298–302
3. M.D. Bomalaski, J.G. Anema, D.E. Coplen, H.P. Koo, T. Rozanski and D.A. Bloom, Delayed presentation of posterior urethral valves a not so benign condition, J Urol 162 (1999), pp. 2130–2132
4. M.S. Jaswon, L. Dibble, S. Puri, J. Davis, J. Young, R. Dave et al., Prospective study of outcome in antenatally diagnosed renal pelvis dilatation. Arch Dis Child 80 (1999), pp. F135–F138.
5. .P. Krueger, B.E. Hardy and B.M. Churchill, Growth in boys and posterior urethral valves: primary valve resection vs upper tract diversion. Urol Clin North Am 7 (1980), pp. 265–272
6. .M. Churchill, G.A. McLorie, A.E. Khoury et al., Emergency treatment and long-term follow-up of posterior urethral valves. Urol Clin North Am 17 (1990), pp. 343–360.
7. Reinberg Y, de Castano I, and Gonzalez R: Influence of initial therapy on progression of renal failure and body growth in children with posterior urethral valves. J Urol 148(2 Pt 2): 532–533, 1992.
8. Tietjen DN, Gloor JM, and Husmann DA: Proximal urinary diversion in the management of posterior urethral valves: is it necessary? J Urol 158(3 Pt 2): 1008–1010, 1997.
9. G.H. Smith, D.A. Canning, S.L. Schulman et al., The long-term outcome of posterior urethral valves treated with primary valve ablation and observation. J Urol 155 (1996), pp. 1730–1734
10. .E. Close, M.C. Carr, M.W. Burns et al., Lower urinary tract changes after early valve ablation in neonates and infants: is early diversion warranted?. J Urol 157 (1997), pp. 984–988.
11. Ellis DG, Fonkalsrud EW and Smith JP. Congenital posterior valves. J.Urol. 1996 95:549,
12. Garg Sk and Lawrie JH. The perineal urethrostomy approach to posterior rethral valves. J.Urol. 1983130,1146,
13. Atwell JD, Posterior urethral valves in British Isles – A multicenter B.A.P.S. Review. J. Ped Surg1974, 18, 280
14. Denes ED, Barthold JS, and Gonzalez R: Early prognostic value of serum creatinine levels in children with posterior urethral valves. J Urol 157: 1441–1443, 1997.
15. Parkhouse H.F. Ban-ett, T.M.,Dhillion MJ, Duffy.P.G., Fay, J., Ransley: Longterm outcome of boys with posterior urethral valve 1988, Br. J. Urol. 62: 59
16. P.Puri, R. Kumar: endoscopic correction of vesiocureteric reflux secondary to posterior urethral valves. J. Urol. 1996: 156;680-682
17. M. Hassan, J.C. Pope IV, J.W. Brock III and M.C. Adams, Vesicoureteral reflux in patients with posterior urethral valves, J Urol 170 (2003), pp. 1677–1680
18. Glassberg KL, Schneider M, Haller Jo, Moel D and Waterhouse K. Observations on persistently dilated ureter after posterior urethral valves ablation. Urology. 1982 20; 20
19. G.H. Smith, D.A. Canning, S.L. Schulman et al., The long-term outcome of posterior urethral valves treated with primary valve ablation and observation. J Urol 155 (1996), pp. 1730–1734
20. Drozdz D, Drozdz M, Gretz N, Mohring K, Mehls O, Scharer K Progression to end-stage renal disease in children with posterior urethral valves. Pediatr Nephrol 1998; 12:630-636
21. Warshaw BL, Ettenger RB, Pennisi AJ, Fine RN Progression to end-stage renal disease in children with obstructive uropathy. J Pediatr 1982; 100:183-187
2. Hendren WH. Posterior urethral valves in boys: a broad clinical spectrum. J Urol 1981; 106: 298–302
3. M.D. Bomalaski, J.G. Anema, D.E. Coplen, H.P. Koo, T. Rozanski and D.A. Bloom, Delayed presentation of posterior urethral valves a not so benign condition, J Urol 162 (1999), pp. 2130–2132
4. M.S. Jaswon, L. Dibble, S. Puri, J. Davis, J. Young, R. Dave et al., Prospective study of outcome in antenatally diagnosed renal pelvis dilatation. Arch Dis Child 80 (1999), pp. F135–F138.
5. .P. Krueger, B.E. Hardy and B.M. Churchill, Growth in boys and posterior urethral valves: primary valve resection vs upper tract diversion. Urol Clin North Am 7 (1980), pp. 265–272
6. .M. Churchill, G.A. McLorie, A.E. Khoury et al., Emergency treatment and long-term follow-up of posterior urethral valves. Urol Clin North Am 17 (1990), pp. 343–360.
7. Reinberg Y, de Castano I, and Gonzalez R: Influence of initial therapy on progression of renal failure and body growth in children with posterior urethral valves. J Urol 148(2 Pt 2): 532–533, 1992.
8. Tietjen DN, Gloor JM, and Husmann DA: Proximal urinary diversion in the management of posterior urethral valves: is it necessary? J Urol 158(3 Pt 2): 1008–1010, 1997.
9. G.H. Smith, D.A. Canning, S.L. Schulman et al., The long-term outcome of posterior urethral valves treated with primary valve ablation and observation. J Urol 155 (1996), pp. 1730–1734
10. .E. Close, M.C. Carr, M.W. Burns et al., Lower urinary tract changes after early valve ablation in neonates and infants: is early diversion warranted?. J Urol 157 (1997), pp. 984–988.
11. Ellis DG, Fonkalsrud EW and Smith JP. Congenital posterior valves. J.Urol. 1996 95:549,
12. Garg Sk and Lawrie JH. The perineal urethrostomy approach to posterior rethral valves. J.Urol. 1983130,1146,
13. Atwell JD, Posterior urethral valves in British Isles – A multicenter B.A.P.S. Review. J. Ped Surg1974, 18, 280
14. Denes ED, Barthold JS, and Gonzalez R: Early prognostic value of serum creatinine levels in children with posterior urethral valves. J Urol 157: 1441–1443, 1997.
15. Parkhouse H.F. Ban-ett, T.M.,Dhillion MJ, Duffy.P.G., Fay, J., Ransley: Longterm outcome of boys with posterior urethral valve 1988, Br. J. Urol. 62: 59
16. P.Puri, R. Kumar: endoscopic correction of vesiocureteric reflux secondary to posterior urethral valves. J. Urol. 1996: 156;680-682
17. M. Hassan, J.C. Pope IV, J.W. Brock III and M.C. Adams, Vesicoureteral reflux in patients with posterior urethral valves, J Urol 170 (2003), pp. 1677–1680
18. Glassberg KL, Schneider M, Haller Jo, Moel D and Waterhouse K. Observations on persistently dilated ureter after posterior urethral valves ablation. Urology. 1982 20; 20
19. G.H. Smith, D.A. Canning, S.L. Schulman et al., The long-term outcome of posterior urethral valves treated with primary valve ablation and observation. J Urol 155 (1996), pp. 1730–1734
20. Drozdz D, Drozdz M, Gretz N, Mohring K, Mehls O, Scharer K Progression to end-stage renal disease in children with posterior urethral valves. Pediatr Nephrol 1998; 12:630-636
21. Warshaw BL, Ettenger RB, Pennisi AJ, Fine RN Progression to end-stage renal disease in children with obstructive uropathy. J Pediatr 1982; 100:183-187
Published
2018-03-04
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