Early outcome following diathermy versus cold knife ablation of posterior urethral valves

Babu, Ramesh; Kumar, R. Dorai

doi:10.1016/j.jpurol.2012.02.014

Cited by 17 publications

(16 citation statements)

References 15 publications

(8 reference statements)

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“…VCUG is considered as the reference radiological study with which to visualize the urethra and, hence, diagnose PUV in children [5,6]. Several authors have reported sensitivity rates ranging between 80 and 90% for the initial diagnosis of PUV [7,8]. Shopfner and Hutch [9] studied the normal urethra on VCUG and described its radiological and anatomical features.…”

Section: Discussionmentioning

confidence: 99%

“…A fixed protocol was used, wherein all patients were initially stabilized with catheterization, intravenous fluids and antibiotics until biochemical parameters/hydration were normalized. A single surgeon performed PUV ablation using 8.5/9 F resectoscope and cold knife at 5, 7, and 12 o'clock positions, as described previously [7]. Per-urethral drainage was kept for 48e72 h post operation.…”

Section: Methodsmentioning

confidence: 99%

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Posterior urethra: Anterior urethra ratio in the evaluation of success following PUV ablation

Babu

Sekar

Ramesh

2016

Journal of Pediatric Urology

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Posterior urethra: Anterior urethra ratio in the evaluation of success following PUV ablation

Babu

Sekar

Ramesh

2016

Journal of Pediatric Urology

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“…Cold knife incision is safe in all neonates and children and is superior to diathermy in relieving PUV obstruction in a single attempt. [8] Vesicostomy was done in 18 (11.8%) cases because of unavailability of small sized cystoscopes. Only 6 (3.9%) patients underwent high ureterostomy as they failed to improve after 48 h period of bladder catheterization.…”

Section: Discussionmentioning

confidence: 99%

Posterior urethral valve: Prognostic factors and renal outcome

Bhadoo

Bajpai

Panda

2014

J Indian Assoc Pediatr Surg

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Objective:The aim was to study the outcome of posterior urethral valve (PUV) cases treated by stepladder protocol and the prognostic factors affecting the outcome.Materials and Methods:Hospital records of all PUV patients treated by stepladder protocol between January 1992 and December 2013 were reviewed. The studied parameters were: Age at presentation, serum creatinine, types of surgical intervention, vesicoureteral reflux (VUR) on initial voiding cystourethrogram (VCUG), renal cortical scars, plasma renin activity (PRA), and glomerular filtration rate (GFR).Results:Of 396 PUV patients treated during the study period, 152 satisfied study criteria. The age at presentation ranged from 2 days to 15 years (mean 31.3 months). The mean follow-up period was 5 years (range: 2-18 years). Primary endoscopic valve ablation was the most common initial procedure. Chronic renal failure was seen in 42.7% patients at the last follow-up. Serum creatinine at presentation, initial PRA levels, initial GFR, and PRA levels at last follow-up were significant predictors of final renal outcome. Age at presentation (<1 vs. >1 year), presence/absence of VUR on initial VCUG and renal cortical scars had no significant correlation with ultimate renal function.Conclusion:Our study confirms the high prognostic significance of initial serum creatinine, PRA levels and GFR in cases with PUV. PRA also holds promise in long-term follow-up of these patients as a marker of progressive renal damage.

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“…For this purpose, preferable pediatric size (8.5F to 11.5F) resectoscope is used in adjunct with diathermy hook electrode in a corresponding working element. Glycine solution (1.5%) is used as an irrigating solution during the procedure [7].…”

Section: (2) 2019mentioning

confidence: 99%

“…Though diathermy fulguration is a common modality of treatment, it has got significant complications like hematuria, diathermy burn, urinary retention, urinary extravasation, urinary incontinence, dribbling, residual valve and urethral stricture [7,5]. In order to minimize and overcome these complications several refinements in the techniques and approaches have been implemented over the time.…”

Section: (2) 2019mentioning

confidence: 99%

Outcome of Cold Knife Incision Compared to Diathermy Fulguration in Posterior Urethral Valve

Khadka

Islam²,

Shameem

et al. 2020

Bang J Urology

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Background: Posterior urethral valves are the most common cause of congenital obstructive lesion in the newborns and infant male child, occurring at the distal portion of the prostatic urethra. Diathermy fulguration of valve is one of the commonest modalities which has been practiced by Pediatric Urologist since decades where success rate ranging from 50-70%. Despite high success rate, post-operative complications like hematuria, urinary tract infections, urinary incontinence, retention of urine, residual valve and urethral stricture may develop in significant number of patients. Incision of the posterior urethral valve by cold knife is one of the modalities in the recent years with insignificant complications and good outcome with success rate ranging from 70-90%. Objective: To compare the efficacy of the cold knife with the diathermy fulguration in the management of the posterior urethral valve. Materials and Methods: This study was conducted in Urology Department of Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from 1st January 2017 till 1st September 2018. A total 48 patients, diagnosed as a case of PUV and who fulfill the selection criteria were divided randomly by simple lottery method into 2 groups consisting of 24 patients in each group. Valve ablation was performed under standard aseptic condition according to groups. Patients were followed up at 3 and 6 months of initial intervention. They were re-evaluated during the follow up with history, clinical examination and investigation findings. Their subjective outcome and objective findings were assessed and compared in between the two groups. Results: There was no significant difference in the age distribution in between the groups (p= 0.083). Within the group, all the variable parameters were significantly improved prior and after the intervention. But, in between the groups, after 6 months of intervention, there was no difference in improvement of urinary flow(p=0.695). Incontinence of urine was not significant (p=1.000). The drop of mean serum creatinine level was not significant (p=0.530). Decrease in Mean PVR was not significant (p=0.684). Maximum flow rate was not significantly improved (p= 0.255). Peri catheter bleeding and residual valve were not significant. Stricture urethra was not found in any patient in both groups. Conclusion: Comparing the findings of the present study, it can be concluded that cold knife incision is equally effective in comparison to diathermy fulguration in the management of posterior urethral valve. Bangladesh Journal of Urology, Vol. 22, No. 2, July 2019 p.118-127

show abstract

Early outcome following diathermy versus cold knife ablation of posterior urethral valves

Cited by 17 publications

References 15 publications

Posterior urethra: Anterior urethra ratio in the evaluation of success following PUV ablation

Posterior urethra: Anterior urethra ratio in the evaluation of success following PUV ablation

Posterior urethral valve: Prognostic factors and renal outcome

Outcome of Cold Knife Incision Compared to Diathermy Fulguration in Posterior Urethral Valve

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