Long‐term Outcome of Boys with Posterior Urethral Valves

Abstract

One hundred and fourteen boys with posterior urethral valves were treated between 1966 and 1975. Four died during the first hospital admission, 6 died from renal failure during childhood, 1 died from other causes and 15 were lost to follow-up. Eighty-eight were reviewed 11 to 22 years after diagnosis and the renal outcome of 98 patients is therefore known. Approximately one-third of patients presented under 1 month of age, between 1 month and 1 year, and over 1 year respectively. Bilateral vesicoureteric reflux was observed in one-quarter of the boys, more frequently in those presenting in the first month of life. Half of the patients were treated by primary valve ablation and half underwent temporary upper tract diversion: the outcome was worse for the diverted group. One-third of the boys had a long-term bad outcome for renal function. This outcome was associated with early presentation, bilateral vesicoureteric reflux and day-time urinary incontinence after the age of 5 years. The association of bad outcome with incontinence points to continuing bladder dysfunction as a major determinant of long-term outcome for renal function.

Clinical and radiological characteristics of Nigerian boys with posterior urethral valves

“…In 1988, Parkhouse et al [17] reported that the prognosis for renal function is poor, with a third of the patients developing renal failure by early adulthood. They identified three factors of importance for the prognosis, namely early diagnosis, bilateral reflux and daytime incontinence after 5 years of age.…”

Outcomes of fetuses with lower urinary tract obstruction treated with vesicoamniotic shunt: A single-institution experience

“…While much of the literature demonstrates a significant decrease in perinatal mortality after VAS, complications are well described and not uncommon [11][12][13][14], and there is a gross lack of high-quality evidence confirming the effectiveness [7,11,12] and benefit of this therapy [14]. The purposes of our study were to review our center's experience with LUTO, and to specifically examine the patient characteristics, treatment patterns, effectiveness, and related complications of VAS, and long-term patient outcomes.…”

Outcome of valve ablation in late‐presenting posterior urethral valves

“…Even now, because of the early damage to the urinary tract, physicians must be diligent about the long-term followup care. Up to 43% of patients may progress to end-stage renal failure by the age of 30 years [5].…”