Bladder function in children with posterior urethral valves: impact of antenatal versus postnatal diagnosis

Detalhes bibliográficos
Autor(a) principal: Sarhan,Osama M.
Data de Publicação: 2022
Outros Autores: Wadie,Bassem S., Al-Kawai,Fouad, Dawaba,Mohamed
Tipo de documento: Artigo
Idioma: eng
Título da fonte: International Braz J Urol (Online)
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382022000100078
Resumo: ABSTRACT Purpose: Posterior urethral valves (PUVs) are the most common cause of congenital bladder obstruction in boys. Our aim was to assess the impact of early diagnosis and fulguration of PUVs on bladder function and compare their functional and urodynamic outcome with children who underwent delayed intervention. Materials and Methods: We retrospectively evaluated 153 patients who underwent primary valve ablation from two tertiary hospitals between 2001 and 2018. Patients have been divided into 2 groups, group 1 included 69 patients who were detected antenatally and underwent early fulguration of PUVs while group 2 included 84 children presented postnatally and underwent delayed valve ablation. The recorded data throughout follow-up in renal function tests, urodynamics and changes in the upper urinary tracts were evaluated and compared. Results: Median age at time of valve ablation was 10 days in group 1 and 7 months in group 2. The median follow-up period was 6.5 and 7 years in group 1 and 2, respectively. Chronic kidney disease (CKD) developed in 15 (22%) boys in group 1 while in group 2 it was observed in 31 (37%), p=0.04. While Q-max, mean bladder capacity and post-void residual (PVR) volumes were comparable in both groups, percent PVR was significantly higher in group 2 (3.27 vs. 1.44, p=0.002). Detrusor overactivity was slightly different in both groups (p = 0.07). Conclusions: Compared to delayed intervention, primary ablation of PUVs during the early neonatal life possibly provides the optimum chance to have optimum renal function without impact on bladder function.
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spelling Bladder function in children with posterior urethral valves: impact of antenatal versus postnatal diagnosisUrinary BladderOveractivePostnatal CareUrethraABSTRACT Purpose: Posterior urethral valves (PUVs) are the most common cause of congenital bladder obstruction in boys. Our aim was to assess the impact of early diagnosis and fulguration of PUVs on bladder function and compare their functional and urodynamic outcome with children who underwent delayed intervention. Materials and Methods: We retrospectively evaluated 153 patients who underwent primary valve ablation from two tertiary hospitals between 2001 and 2018. Patients have been divided into 2 groups, group 1 included 69 patients who were detected antenatally and underwent early fulguration of PUVs while group 2 included 84 children presented postnatally and underwent delayed valve ablation. The recorded data throughout follow-up in renal function tests, urodynamics and changes in the upper urinary tracts were evaluated and compared. Results: Median age at time of valve ablation was 10 days in group 1 and 7 months in group 2. The median follow-up period was 6.5 and 7 years in group 1 and 2, respectively. Chronic kidney disease (CKD) developed in 15 (22%) boys in group 1 while in group 2 it was observed in 31 (37%), p=0.04. While Q-max, mean bladder capacity and post-void residual (PVR) volumes were comparable in both groups, percent PVR was significantly higher in group 2 (3.27 vs. 1.44, p=0.002). Detrusor overactivity was slightly different in both groups (p = 0.07). Conclusions: Compared to delayed intervention, primary ablation of PUVs during the early neonatal life possibly provides the optimum chance to have optimum renal function without impact on bladder function.Sociedade Brasileira de Urologia2022-01-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382022000100078International braz j urol v.48 n.1 2022reponame:International Braz J Urol (Online)instname:Sociedade Brasileira de Urologia (SBU)instacron:SBU10.1590/s1677-5538.ibju.2021.0046info:eu-repo/semantics/openAccessSarhan,Osama M.Wadie,Bassem S.Al-Kawai,FouadDawaba,Mohamedeng2022-01-10T00:00:00Zoai:scielo:S1677-55382022000100078Revistahttp://www.brazjurol.com.br/ONGhttps://old.scielo.br/oai/scielo-oai.php||brazjurol@brazjurol.com.br1677-61191677-5538opendoar:2022-01-10T00:00International Braz J Urol (Online) - Sociedade Brasileira de Urologia (SBU)false
dc.title.none.fl_str_mv Bladder function in children with posterior urethral valves: impact of antenatal versus postnatal diagnosis
title Bladder function in children with posterior urethral valves: impact of antenatal versus postnatal diagnosis
spellingShingle Bladder function in children with posterior urethral valves: impact of antenatal versus postnatal diagnosis
Sarhan,Osama M.
Urinary Bladder
Overactive
Postnatal Care
Urethra
title_short Bladder function in children with posterior urethral valves: impact of antenatal versus postnatal diagnosis
title_full Bladder function in children with posterior urethral valves: impact of antenatal versus postnatal diagnosis
title_fullStr Bladder function in children with posterior urethral valves: impact of antenatal versus postnatal diagnosis
title_full_unstemmed Bladder function in children with posterior urethral valves: impact of antenatal versus postnatal diagnosis
title_sort Bladder function in children with posterior urethral valves: impact of antenatal versus postnatal diagnosis
author Sarhan,Osama M.
author_facet Sarhan,Osama M.
Wadie,Bassem S.
Al-Kawai,Fouad
Dawaba,Mohamed
author_role author
author2 Wadie,Bassem S.
Al-Kawai,Fouad
Dawaba,Mohamed
author2_role author
author
author
dc.contributor.author.fl_str_mv Sarhan,Osama M.
Wadie,Bassem S.
Al-Kawai,Fouad
Dawaba,Mohamed
dc.subject.por.fl_str_mv Urinary Bladder
Overactive
Postnatal Care
Urethra
topic Urinary Bladder
Overactive
Postnatal Care
Urethra
description ABSTRACT Purpose: Posterior urethral valves (PUVs) are the most common cause of congenital bladder obstruction in boys. Our aim was to assess the impact of early diagnosis and fulguration of PUVs on bladder function and compare their functional and urodynamic outcome with children who underwent delayed intervention. Materials and Methods: We retrospectively evaluated 153 patients who underwent primary valve ablation from two tertiary hospitals between 2001 and 2018. Patients have been divided into 2 groups, group 1 included 69 patients who were detected antenatally and underwent early fulguration of PUVs while group 2 included 84 children presented postnatally and underwent delayed valve ablation. The recorded data throughout follow-up in renal function tests, urodynamics and changes in the upper urinary tracts were evaluated and compared. Results: Median age at time of valve ablation was 10 days in group 1 and 7 months in group 2. The median follow-up period was 6.5 and 7 years in group 1 and 2, respectively. Chronic kidney disease (CKD) developed in 15 (22%) boys in group 1 while in group 2 it was observed in 31 (37%), p=0.04. While Q-max, mean bladder capacity and post-void residual (PVR) volumes were comparable in both groups, percent PVR was significantly higher in group 2 (3.27 vs. 1.44, p=0.002). Detrusor overactivity was slightly different in both groups (p = 0.07). Conclusions: Compared to delayed intervention, primary ablation of PUVs during the early neonatal life possibly provides the optimum chance to have optimum renal function without impact on bladder function.
publishDate 2022
dc.date.none.fl_str_mv 2022-01-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
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dc.relation.none.fl_str_mv 10.1590/s1677-5538.ibju.2021.0046
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dc.publisher.none.fl_str_mv Sociedade Brasileira de Urologia
publisher.none.fl_str_mv Sociedade Brasileira de Urologia
dc.source.none.fl_str_mv International braz j urol v.48 n.1 2022
reponame:International Braz J Urol (Online)
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collection International Braz J Urol (Online)
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