Posterior urethral valves: long-term outcome |
| |
Authors: | Paolo Caione Simona Gerocarni Nappo |
| |
Institution: | (1) Division of Pediatric Urology, Department of Nephrology-Urology, “Bambino Ges?” Children’s Hospital and Research Institute, Piazza S. Onofrio, 4, 00165 Rome, Italy |
| |
Abstract: | Posterior urethral valves represent the most common cause of bladder outlet obstruction in infancy that impairs renal and
bladder function. Long-term outcome of patients with previous PUV is evaluated. Patients over 18 years of age, treated from
1982 to 1995 before the age of 3 years were considered. Previous surgery, renal function, bladder activity, urinary incontinence,
and fertility/sexual activity were evaluated. Clinical interview, creatinine clearance, uroflowmetry with ultrasound post-void
urine residue, and self-administered questionnaire were recorded. Out of 45 identified records, 24 patients (53.3%) accepted
to be enrolled (age 18–34 years, mean 23 years). The mean follow-up was 19.5 years (16–30 years). Out of the 21 excluded patients,
20 did not reply to the clinical interview and 1 died at age of 6 years. All the 24 patients had early endoscopic section
of PUV; nine also received transient ureterocutaneostomy or vesicostomy. Ureteroneocystostomy was performed in five patients
and ureterocystoplasty with unilateral nephrectomy in two. At follow-up chronic renal failure was detected in 13 patients
(54.1%) and 9 (37.5%) had arterial hypertension. End-stage renal disease developed in five patients (20.8%): three had successful
renal transplantation and two were in dialysis. Lower urinary tract symptoms were present in seven patients (29.1%). No significant
fertility deficit and sexual dysfunction were observed in 23 patients, while 1 patient was azoospermic. No paternity was reported
so far. Long-term outcome of patients with previously treated PUV is mandatory. Kidney, bladder, and sexual functions should
be monitored till adulthood to verify any modified behaviour. |
| |
Keywords: | |
本文献已被 PubMed SpringerLink 等数据库收录! |
|