Controlled Outcomes for Achievement of Urinary Continence among Boys Treated for Posterior Urethral Valves

Jalkanen, Jenni; Heikkilä, Jukka; Kyrklund, Kristiina; Taskinen, Seppo

doi:10.1016/j.juro.2016.02.2968

Cited by 18 publications

(9 citation statements)

References 31 publications

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“…In general, boys with PUV achieve daytime and nighttime urinary continence significantly later than healthy controls. 12 It is difficult to expect an immediate effect of TUI for boys with refractory DUI. We concluded that the effects of TUI for boys with refractory DUI due to PUV may sometimes be limited and care should be taken in deciding treatment.…”

Section: Discussionmentioning

confidence: 99%

<p>Is Endoscopic Transurethral Incision Really Effective for Boys with Refractory Daytime Incontinence?</p>

Morizawa

Aoki

Gotoh

et al. 2020

RRU

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To determine the clinical efficacy of endoscopic transurethral incision (TUI) for boys with refractory daytime incontinence due to a posterior urethral valve with or without nocturnal enuresis. Patients and Methods: A total of 20 boys with daytime incontinence were assessed. Twelve boys underwent TUI (TUI+ group) and eight boys continued receiving oral drugs (TUI-group). The primary endpoint was the cure rate associated with TUI or NE in both groups. Results: Only two boys achieved daytime continence 6 months after TUI, but no boys were cured of nocturnal enuresis 6 months after TUI. The median time to daytime continence was significantly longer in the TUI+ than in the TUI-group (52 vs 27 months, respectively; log rank P = 0.041) and the median time to dry nights was significantly longer in the TUI+ than in the TUI-group (56 vs 36 months, respectively; log rank P = 0.021). Conclusion: TUI might be not effective in boys with refractory daytime incontinence.

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Section: Discussionmentioning

confidence: 99%

<p>Is Endoscopic Transurethral Incision Really Effective for Boys with Refractory Daytime Incontinence?</p>

Morizawa

Aoki

Gotoh

et al. 2020

RRU

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“…All children had primary valve ablation using a cold knife urethrotome with a median age at valve ablation of 10 days (IQR, 6-18) and 7 months (IQR, [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] for group 1 and 2, respectively. After valve ablation was done, a regular follow--up with clinical examination, serum creatinine, urinalysis, and renal US and VCUG were performed at intervals.…”

Section: Methodsmentioning

confidence: 99%

“…Toilet training is often delayed in children with PUVs. Patients with PUVs achieve daytime and nighttime urinary continence significantly later than their healthy peers (14). Neonatal valve ablation was reported to protect the bladder and allow normal cycling, which helps in bladder healing and gives a chance for the bladder to revert to a normal voiding pattern and avoid voiding dysfunction (15).…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2022

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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 followup 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 signifi cantly 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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“…In the longer term, patients with posterior urethral valves achieve daytime and nighttime urinary continence significantly later thaen their healthy peers. 51 Valve associated morbidity continues through adolescence and into adult life. Adult valve patients with ongoing incontinence report more sleep disturbance and regard themselves more phyisically disabled, those with renal insufficiency report lower quality of life in several domains.…”

Section: Posterior Urethral Valvesmentioning

confidence: 99%

Lifelong Congenital Urology: The Challenges for Patients and Surgeons

et al. 2019

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We thank the reviewers and the Journal for their support with this manuscript. We recognize the complex nature of this subject and are eager to get our submission right. Your input is greatly valued.Reviewer #2: I think the paper is improved and more logical in its flow in the current version. Thank you.However, it does not contain very much concrete information/advice and as such I believe it should be shortened. I suggested this in the previous review as well but the new version is longer than before.Further, the purpose of the statement still seem a bit unclear. I would suggest that the authors add a well-defined purpose at the end of the introduction so that the paper can be read in that context.An excellent suggestionwe have added this.Finally, for table 1, lower limits for observations should be noted. It is not really useful for the reader to know that some studies didn't report on the problem and this does not work as lower limits. Reviewer Comments 1 st review Comments to Author:Reviewer #1: The authors present a superficial review or consensus of the challenges posed by patients who need transitional urology care. This topic is not new. This paper would have been informative 5 years ago. As written, there are few or no relevant data, the English needs editing, and it does not add to the current literature. The resources used to meet in Copenhagen to finalize this paper could have been put to better use.We thank the reviewer for their comments. We agree that this is a topic that has been in existence since D.I.Williams, Christopher Woodhouse and Phillip Ransley (and others) began to provide lifelong care for these patients. To date it has been relatively easy to stimulate interest in paediatric urologists who have the cohort of older patientsit remains difficult to stimulate interest in adult practitioners where the need is becoming

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Controlled Outcomes for Achievement of Urinary Continence among Boys Treated for Posterior Urethral Valves

Abstract: Patients with posterior urethral valves achieve daytime and nighttime urinary continence significantly later than their healthy peers. Prenatal or neonatal diagnosis and high serum creatinine are associated with later attainment of continence.

Cited by 18 publications

References 31 publications

<p>Is Endoscopic Transurethral Incision Really Effective for Boys with Refractory Daytime Incontinence?</p>

<p>Is Endoscopic Transurethral Incision Really Effective for Boys with Refractory Daytime Incontinence?</p>

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

Lifelong Congenital Urology: The Challenges for Patients and Surgeons

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