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Protective factors in posterior urethral valves.
J Urol. 1988 Nov; 140(5):993-6.JU

Abstract

Patients with posterior urethral valves may present with or contract renal insufficiency. High intravesical pressure that is transmitted to the upper urinary tract in utero is a likely contributing cause. We have identified 3 anatomical associations with posterior urethral valves that provide a pressure "pop-off" mechanism resulting in preservation of better renal function: 1) the syndrome of posterior urethral valves, unilateral vesicoureteral reflux and renal dysplasia; 2) large congenital type bladder diverticula and 3) urinary extravasation with or without urinary ascites. Followup of 71 boys with posterior urethral valves was sufficient to permit long-term analysis. Serum creatinine was used as an index of renal function and prognosis. Of the 71 boys 20 (28 per cent) had 1 of the 3 protective mechanisms. Only 1 child (5 per cent) had a serum creatinine greater than 1.0 mg. per cent. Of the remaining 51 boys without a "pop-off" mechanism 20 (39 per cent) had serum creatinine greater than 1.0 mg. per cent and 7 had already progressed to renal dialysis and/or transplantation. The difference in serum creatinine was statistically significant (p less than 0.01). Thus, the syndrome of posterior urethral valves, unilateral vesicoureteral reflux and renal dysplasia; large congenital bladder diverticula and urinary extravasation can serve as a "pop-off" mechanism to buffer high pressures in the urinary tract and to lead to the preservation of better renal function in boys with posterior urethral valves.

Authors+Show Affiliations

Division of Urology, Children's Hospital of Philadelphia, Pennsylvania 19104.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

3139895

Citation

Rittenberg, M H., et al. "Protective Factors in Posterior Urethral Valves." The Journal of Urology, vol. 140, no. 5, 1988, pp. 993-6.
Rittenberg MH, Hulbert WC, Snyder HM, et al. Protective factors in posterior urethral valves. J Urol. 1988;140(5):993-6.
Rittenberg, M. H., Hulbert, W. C., Snyder, H. M., & Duckett, J. W. (1988). Protective factors in posterior urethral valves. The Journal of Urology, 140(5), 993-6.
Rittenberg MH, et al. Protective Factors in Posterior Urethral Valves. J Urol. 1988;140(5):993-6. PubMed PMID: 3139895.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Protective factors in posterior urethral valves. AU - Rittenberg,M H, AU - Hulbert,W C, AU - Snyder,H M,3rd AU - Duckett,J W, PY - 1988/11/1/pubmed PY - 1988/11/1/medline PY - 1988/11/1/entrez SP - 993 EP - 6 JF - The Journal of urology JO - J Urol VL - 140 IS - 5 N2 - Patients with posterior urethral valves may present with or contract renal insufficiency. High intravesical pressure that is transmitted to the upper urinary tract in utero is a likely contributing cause. We have identified 3 anatomical associations with posterior urethral valves that provide a pressure "pop-off" mechanism resulting in preservation of better renal function: 1) the syndrome of posterior urethral valves, unilateral vesicoureteral reflux and renal dysplasia; 2) large congenital type bladder diverticula and 3) urinary extravasation with or without urinary ascites. Followup of 71 boys with posterior urethral valves was sufficient to permit long-term analysis. Serum creatinine was used as an index of renal function and prognosis. Of the 71 boys 20 (28 per cent) had 1 of the 3 protective mechanisms. Only 1 child (5 per cent) had a serum creatinine greater than 1.0 mg. per cent. Of the remaining 51 boys without a "pop-off" mechanism 20 (39 per cent) had serum creatinine greater than 1.0 mg. per cent and 7 had already progressed to renal dialysis and/or transplantation. The difference in serum creatinine was statistically significant (p less than 0.01). Thus, the syndrome of posterior urethral valves, unilateral vesicoureteral reflux and renal dysplasia; large congenital bladder diverticula and urinary extravasation can serve as a "pop-off" mechanism to buffer high pressures in the urinary tract and to lead to the preservation of better renal function in boys with posterior urethral valves. SN - 0022-5347 UR - https://www.unboundmedicine.com/medline/citation/3139895/Protective_factors_in_posterior_urethral_valves_ L2 - https://www.jurology.com/doi/10.1016/s0022-5347(17)41908-2?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -