Posterior Urethral Valves: A Study of Urinary Control after Operation

Whitaker, Robert H.; Keeton, James E.; Williams, D. Innes

doi:10.1016/s0022-5347(17)60673-6

Cited by 49 publications

(12 citation statements)

References 5 publications

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“…Whitaker et al [3] found that only 29% of 112 boys were fully continent at a mean age of 6.5 years. Attainment of day and night continence is delayed in valve patients and was 19% at five years, 46% at 10 years and all except one at 20 years in Smith et al .…”

Section: Posterior Urethral Valvesmentioning

confidence: 99%

A review of urodynamic evaluation in children and its role in the management of boys with posterior urethral valves

Desai¹

2007

Indian J Urol

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Posterior urethral valves are the commonest cause of lower urinary tract outflow obstruction in male infants with an estimated incidence of 1:5000 male infants and 1:25,000 live births. Despite treatment with fulguration of the obstructing valves, bladder function is abnormal in up to 70% of older children and adolescents. Bladder dysfunction causes morbidity e.g. urinary incontinence and has been implicated in the late deterioration of renal function in this population. A poor understanding and inappropriate management of bladder dysfunction can result in unnecessary morbidity, which can handicap a child for life. Any method that measures function or dysfunction of the lower urinary tract constitutes a urodynamics investigation. Broadly, the investigations can be classified into simple or noninvasive urodynamics and invasive urodynamics. The objective of urodynamics assessments in children is to reproduce the patient's complaints or symptoms. Video urodynamics can provide additional information that may contribute to a further understanding of the problem under investigation. Urodynamics provides a useful tool to test the efficacy of treatment as well as determine any refinements necessary to improve the outcome of such treatment.

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Section: Posterior Urethral Valvesmentioning

confidence: 99%

A review of urodynamic evaluation in children and its role in the management of boys with posterior urethral valves

Desai¹

2007

Indian J Urol

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“…However, sonography results show poor bladder emptying in 69% of the patients studied. Bladder dysfunction with incontinence and deformation of the urethral sphincter has been documented to be present in 13%e38% of patients after resection of the valve [17]. Myogenic failure with large residuals and high voiding pressure has been described by Bauer et al [18].…”

Section: Discussionmentioning

confidence: 97%

Pyospermia in an adult cohort with persistent lower urinary tract symptoms and a history of ablated posterior urethral valve

Schober

Dulabon

Gor

et al. 2010

Journal of Pediatric Urology

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“…However, the advantages outweigh the limitations. The child remains dry and very active without the social stigma of the incon tinence so likely to occur as a result of his low-density heavy urine flow [14,15]. At puberty, he bypasses the danger of pursuing dryness.…”

Section: Discussionmentioning

confidence: 99%

Normal Growth with Renal Insufficiency Owing to Posterior Urethral Valves: Value of Long-Term Diversion

1992

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Twenty-five patients with posterior urethral valves have been monitored for 10-29 years (mean 18 years). Eight underwent diversion because of impaired renal function (creatinine > 0.8 mg/dl) accompanied by unimproved upper tract form and function after valve ablation. In the nondiverted group, 6 patients (35%) progressed to renal failure; in the diverted group 5 patients (63%) did so (p = 0.30). Of 13 patients whose lowest serum creatinine in the first year after valve ablation was > 0.8 mg/dl, 9 (69 %) went on to renal failure (p = 0.02); in the remaining 12 patients, only 2 (17%) did so (p = 0.008). The mean age for renal failure was 13 years for both groups. The Tanner scale rating (mean percent height) for all patients at 10 years was 61% for the diverted group and 35% for those without diversion (p = 0.004). When the patients treated after the age of 1 year (n = 7) were excluded from the calculation, the rating remained different (54% diversion, 26% no diversion; p = 0.012). We conclude that the boy born with urethral valves and serious upper tract damage is at risk for renal failure, especially during the teen years. An undefined relationship appears to exist between urinary obstruction and growth. In our study, the boys who underwent diversion continued to grow along a normal Tanner height curve.

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Posterior Urethral Valves: A Study of Urinary Control after Operation

Cited by 49 publications

References 5 publications

A review of urodynamic evaluation in children and its role in the management of boys with posterior urethral valves

A review of urodynamic evaluation in children and its role in the management of boys with posterior urethral valves

Pyospermia in an adult cohort with persistent lower urinary tract symptoms and a history of ablated posterior urethral valve

Normal Growth with Renal Insufficiency Owing to Posterior Urethral Valves: Value of Long-Term Diversion

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