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Short-Term Outcomes of Treatment of Boys with Posterior Urethral Valves.
Niger Med J. 2019 Nov-Dec; 60(6):306-311.NM

Abstract

Background

Posterior urethral valve (PUV) is a significant cause of morbidity and mortality among male children resulting in renal failure in 25%-30% before adolescence irrespective of initial treatment. This study aimed at evaluating the early outcomes of children managed for PUV.

Materials and Methods

This was a prospective study of all children who were treated for PUV between 2012 and 2016 at a single referral institution. Information reviewed included demographic and clinical data, imaging findings, pre- and post-operative serum electrolytes, and postoperative renal outcomes.

Results

Twenty-nine male children were managed for PUV at a median age of 6 months including 7 (24.1%) neonates. Two (6.9%) patients had antenatal diagnosis. Micturating cystourethrogram confirmed PUV in all patients. Fourteen (48.3%) patients had impaired renal function (IRF) at presentation and 8 (57%) had improved renal function (RF) after initial catheter drainage. The mean creatinine at presentation was 1.86 ± 1.69 mg/dl and the mean serum creatinine following initial catheter drainage was 0. 93 ± 0.49 mg/dl (P = 0.003). For those patients with normal RF, the mean creatinine at presentation was 0.81 ± 0.22 mg/dl versus 0.74 ± 0.21 mg/dl (P = 0.012), following initial catheter drainage. Children with IRF on admission had mean creatinine at presentation of 2.61 ± 2.00 mg/dl compared to 1.17 ± 0.53 mg/dl (P = 0.002) after initial catheter drainage. Valve ablation was achieved with Mohan's valvotome in 26 (96.3%) patients. All patients had good urine stream at a median follow-up of 5 months. Four (13.8%) patients developed IRF at follow-up. Renal outcomes of patients presenting before 1 year and those presenting after 1 year were similar. Two children died preoperative of urosepsis and one out of hospital death given an overall mortality of 10.3% (n = 3).

Conclusion

There was significant improvement in RF after initial catheter drainage. The incidence of IRF at follow-up was 13.8%. Long-term follow-up is necessary to identify patients at risk of end-stage renal disease.

Authors+Show Affiliations

Department of Surgery, Division of Paediatric Surgery, University of Ilorin/University of Ilorin Teaching Hospital, Ilorin, Nigeria.Department of Surgery, Division of Paediatric Surgery, University of Ilorin/University of Ilorin Teaching Hospital, Ilorin, Nigeria.Department of Surgery, Division of Paediatric Surgery, University of Ilorin/University of Ilorin Teaching Hospital, Ilorin, Nigeria.Department of Surgery, Federal Medical Center, Owo, Nigeria.Department of Surgery, Division of Paediatric Surgery, University of Ilorin/University of Ilorin Teaching Hospital, Ilorin, Nigeria.Department of Paediatric, Division of Nephrology, University of Ilorin/University of Ilorin Teaching Hospital, Ilorin, Nigeria.Department of Surgery, Division of Paediatric Surgery, University of Ilorin/University of Ilorin Teaching Hospital, Ilorin, Nigeria.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32180661

Citation

Nasir, Abdulrasheed A., et al. "Short-Term Outcomes of Treatment of Boys With Posterior Urethral Valves." Nigerian Medical Journal : Journal of the Nigeria Medical Association, vol. 60, no. 6, 2019, pp. 306-311.
Nasir AA, Oyinloye AO, Abdur-Rahman LO, et al. Short-Term Outcomes of Treatment of Boys with Posterior Urethral Valves. Niger Med J. 2019;60(6):306-311.
Nasir, A. A., Oyinloye, A. O., Abdur-Rahman, L. O., Bamigbola, K. T., Abdulraheem, N. T., Adedoyin, O. T., & Adeniran, J. O. (2019). Short-Term Outcomes of Treatment of Boys with Posterior Urethral Valves. Nigerian Medical Journal : Journal of the Nigeria Medical Association, 60(6), 306-311. https://doi.org/10.4103/nmj.NMJ_118_18
Nasir AA, et al. Short-Term Outcomes of Treatment of Boys With Posterior Urethral Valves. Niger Med J. 2019 Nov-Dec;60(6):306-311. PubMed PMID: 32180661.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Short-Term Outcomes of Treatment of Boys with Posterior Urethral Valves. AU - Nasir,Abdulrasheed A, AU - Oyinloye,Adewale O, AU - Abdur-Rahman,Lukman O, AU - Bamigbola,Kayode T, AU - Abdulraheem,Nurudeen T, AU - Adedoyin,Olanrewaju T, AU - Adeniran,James O, Y1 - 2020/02/24/ PY - 2018/09/02/received PY - 2019/09/22/revised PY - 2019/11/07/accepted PY - 2020/3/18/entrez PY - 2020/3/18/pubmed PY - 2020/3/18/medline KW - Congenital obstructive posterior urethral membrane KW - posterior urethral valves KW - renal impairment KW - vesicoureteric reflux SP - 306 EP - 311 JF - Nigerian medical journal : journal of the Nigeria Medical Association JO - Niger Med J VL - 60 IS - 6 N2 - Background: Posterior urethral valve (PUV) is a significant cause of morbidity and mortality among male children resulting in renal failure in 25%-30% before adolescence irrespective of initial treatment. This study aimed at evaluating the early outcomes of children managed for PUV. Materials and Methods: This was a prospective study of all children who were treated for PUV between 2012 and 2016 at a single referral institution. Information reviewed included demographic and clinical data, imaging findings, pre- and post-operative serum electrolytes, and postoperative renal outcomes. Results: Twenty-nine male children were managed for PUV at a median age of 6 months including 7 (24.1%) neonates. Two (6.9%) patients had antenatal diagnosis. Micturating cystourethrogram confirmed PUV in all patients. Fourteen (48.3%) patients had impaired renal function (IRF) at presentation and 8 (57%) had improved renal function (RF) after initial catheter drainage. The mean creatinine at presentation was 1.86 ± 1.69 mg/dl and the mean serum creatinine following initial catheter drainage was 0. 93 ± 0.49 mg/dl (P = 0.003). For those patients with normal RF, the mean creatinine at presentation was 0.81 ± 0.22 mg/dl versus 0.74 ± 0.21 mg/dl (P = 0.012), following initial catheter drainage. Children with IRF on admission had mean creatinine at presentation of 2.61 ± 2.00 mg/dl compared to 1.17 ± 0.53 mg/dl (P = 0.002) after initial catheter drainage. Valve ablation was achieved with Mohan's valvotome in 26 (96.3%) patients. All patients had good urine stream at a median follow-up of 5 months. Four (13.8%) patients developed IRF at follow-up. Renal outcomes of patients presenting before 1 year and those presenting after 1 year were similar. Two children died preoperative of urosepsis and one out of hospital death given an overall mortality of 10.3% (n = 3). Conclusion: There was significant improvement in RF after initial catheter drainage. The incidence of IRF at follow-up was 13.8%. Long-term follow-up is necessary to identify patients at risk of end-stage renal disease. SN - 0300-1652 UR - https://www.unboundmedicine.com/medline/citation/32180661/Short_Term_Outcomes_of_Treatment_of_Boys_with_Posterior_Urethral_Valves_ L2 - http://www.nigeriamedj.com/article.asp?issn=0300-1652;year=2019;volume=60;issue=6;spage=306;epage=311;aulast=Nasir DB - PRIME DP - Unbound Medicine ER -
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