Urethral ratio on voiding cystourethrogram: A comparative method to assess success of posterior urethral valve ablation

Gupta, Rahul; Shah, Hemanshi; Jadhav, Vinay; Gupta, Abhaya; Prakash, Avinash; Sanghvi, Bejal; Parelkar, Sandesh

doi:10.1016/j.jpurol.2009.05.009

Cited by 19 publications

(29 citation statements)

References 6 publications

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“…Rahul Gupta et al, in another study foud a post fulguration urethral ratio of 2.5-3 was acceptable postoperatively. 12 One of the limitations of the present study is the lack of sufficient observations at different criterion points for the ROC analysis. Selective reporting of cases in the Tertiary care setting like ours limits wider application of the diagnostic cut off we selected in this study.…”

Section: Discussionmentioning

confidence: 87%

“…Urethral ratio (UR), calculated by dividing the posterior urethral diameter by the anterior urethral diameter as seen on VCUG, gives an objective measurement of adequacy of valve ablation.8 Studies have shown a reduction of UR to a postoperative value of 2.5 to 3.5 is acceptable. 8,9 The amount of posterior urethral dilatation that mandates a cystoscopic evaluation to rule our milder variants of PUV is still arbitrary and has a lot of individual variations based on the surgeon's experience. This is because the posterior urethral dilatation is not so extreme and the secondary bladder changes and vesicoureteric reflux are not seen.…”

Section: Introductionmentioning

confidence: 99%

“…Studies on urethral ratio in controls have varying values which range from 1.73 to 2.6. 8,9 Postoperative values of urethral ratio greater than 3 should be evaluated for incomplete fulguration. 10 This study aims to evaluate the role of urethral ratio beyond which here is higher probability of finding a mild variant of urethral valve thereby identifying patients who need to undergo a cystoscopic evaluation.…”

Section: Introductionmentioning

confidence: 99%

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Utility of urethral ratio in voiding cystourethrogram to identify milder variants of posterior urethral valves

et al. 2018

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Background: Majority of patients with posterior urethral valves are diagnosed antenatally. Few patients present later in childhood with milder variants of the disease where the radiological findings are not very apparent. In this study, we aim to evaluate the role of urethral ratio beyond which here is higher probability of finding a mild variant of urethral valve thereby identifying patients who need to undergo a cystoscopic evaluation. Methods: This study was conducted in the Department of Paediatric Surgery between 2016 and 2017. 48 male patients who presented with either urinary tract infection or other lower urinary tract symptoms were included in the study. The candidates were examined and evaluated with an ultrasound followed by a voiding cystourethrogram (VCUG). The Urethral ratio was calculated. All patients then underwent a cystoscopy to rule out the presence of valve. We analyzed the data in Stata IC 15 statistical software and R statistical computing environment. Results: Of the 48 children recruited to the study, the median age of those with posterior urethral valve on cystoscopy was 8(IQ 3-18) and those without valves was 9(IQ 6.5-21) months. There was a statistically significant difference in the quality of urinary stream, straining on micturition, presence or absence of palpable bladder between the two groups (p value <0.05). The mean urethral ratio in the first group with PUV was 2.25(CI 2.02 to 2.48) and that in the second group with no urethral valve was 1.48(CI 1.32 to 1.65). with cut-off point of Urethral ratio at 2 the specificity and positive predictive value for the presence of PUV reached 100%.Conclusions: The present study indicates the calculation of urethral ratio on VCUG is an objective method for assessment of milder variants of PUV. In the present study, a Urethral ratio greater than 2 had a positive predictive value of 100% and would mandate a cystoscopic evaluation.

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Section: Discussionmentioning

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Utility of urethral ratio in voiding cystourethrogram to identify milder variants of posterior urethral valves

et al. 2018

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“…Eleven of 30 (36%) PUV patients in the report [1] had a pre-fulguration urethral ratio less than or equal to 3! It is obvious that urethral ratio, as per the authors' criteria, cannot be applied to test the adequacy of valve ablation in this group.…”

mentioning

confidence: 83%

“…We read with interest the paper on the use of urethral ratio as a tool to assess the adequacy of valve ablation in PUV [1]. The authors compared the urethral ratios of children with PUV pre-and post-fulguration, as well as urethral ratios in the control group.…”

mentioning

confidence: 99%

Comment on “Urethral ratio on voiding cystourethrogram: A comparative method to assess the success of posterior urethral valve ablation”

Chandrasekharam

2010

Journal of Pediatric Urology

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Posterior Urethral Valves and Ureterovesical Junction Obstruction

Snodgrass

2013

Pediatric Urology

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Urethral ratio on voiding cystourethrogram: A comparative method to assess success of posterior urethral valve ablation

Cited by 19 publications

References 6 publications

Utility of urethral ratio in voiding cystourethrogram to identify milder variants of posterior urethral valves

Utility of urethral ratio in voiding cystourethrogram to identify milder variants of posterior urethral valves

Comment on “Urethral ratio on voiding cystourethrogram: A comparative method to assess the success of posterior urethral valve ablation”

Posterior Urethral Valves and Ureterovesical Junction Obstruction

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