Insight into Posterior Urethral Valve from Our Experience: Paradigm Appended to Abate Renal Failure.
Albumin creatinine ratio
bladder neck incision
chronic kidney disease
creatinine clearance
detrusor pressure
end stage renal failure
posterior urethral valve
rhabdo sphincter spasm
ureterovesical junction obstruction
urodynamic study
vesicoureteral reflux
voiding cystourethrogram
Journal
Journal of Indian Association of Pediatric Surgeons
ISSN: 0971-9261
Titre abrégé: J Indian Assoc Pediatr Surg
Pays: India
ID NLM: 101179870
Informations de publication
Date de publication:
Historique:
received:
26
10
2019
revised:
23
03
2020
accepted:
06
05
2020
entrez:
21
12
2020
pubmed:
22
12
2020
medline:
22
12
2020
Statut:
ppublish
Résumé
The objective of the study was to share our experience of management of posterior urethral valve (PUV) and to suggest a paradigm to impede upstaging of chronic kidney disease (CKD) and prevent end-stage renal failure (ESRF). We have treated 332 patient of PUV from March 2005 to April 2016, Of which 272 case records had adequate data to be analyzed. The mean age was 2.48 years (range: 1 day-18 years). We did primary fulguration in 231 patients, of which five patients needed bilateral ureterostomy for obstinate high creatinine level. The remaining 36 patients had primary fulguration done elsewhere. The mean duration of follow-up was 7.8 years (range 3-14 years). In the end of this study, 10 patients had down staging in CKD, 36 patients had up staging in CKD, and 9 patients ended in ESRF (3.8%). Detection of deterioration of renal function with creatinine clearance along with identifying the causes of deterioration and necessary interventions would help to arrest upstaging of CKD otherwise that might end in ESRF. From this study and reviewing the literature, we presume that the rhabdosphincter spasm underneath actually renders bladder outlet obstruction, and cusps of PUV, particularly in neonates, amplify the obstruction, following that bladder outlet obstruction cascades detrusor hypertrophy, bladder neck hypertrophy/obstructions, and ureterovesical junction obstruction/reflux, causing gradual damage to the bladder and upper tract and deterioration of renal function as a consequence.
Identifiants
pubmed: 33343111
doi: 10.4103/jiaps.JIAPS_136_19
pii: JIAPS-25-297
pmc: PMC7731998
doi:
Types de publication
Journal Article
Langues
eng
Pagination
297-305Informations de copyright
Copyright: © 2020 Journal of Indian Association of Pediatric Surgeons.
Déclaration de conflit d'intérêts
There are no conflicts of interest.
Références
J Indian Assoc Pediatr Surg. 2019 Jan-Mar;24(1):4-14
pubmed: 30686881
Urology. 2017 Jan;99:278-280
pubmed: 27720773
J Pediatr Surg. 1993 May;28(5):701-4; discussion 704-6
pubmed: 8340863
Br J Urol. 1997 Feb;79(2):271-5
pubmed: 9052482
Front Pediatr. 2017 Jul 13;5:152
pubmed: 28752084
J Urol. 1997 Sep;158(3 Pt 2):1281-5
pubmed: 9258195
Urology. 2007 Aug;70(2):355-6; discussion 356-7
pubmed: 17826506
J Urol. 1999 Dec;162(6):2130-2
pubmed: 10569602
Urol Res. 1998;26(5):331-6
pubmed: 9840342
J Urol. 1971 Aug;106(2):298-307
pubmed: 5099322
N Engl J Med. 1986 Jul 31;315(5):336-40
pubmed: 3724830
Urol Clin North Am. 1990 May;17(2):343-60
pubmed: 2186540
J Urol. 2007 Nov;178(5):2142-7; discussion 2147-9
pubmed: 17870121
Urology. 2008 Nov;72(5):1022-5
pubmed: 18585762
Urol Int. 2009;82(1):77-80
pubmed: 19172102
J Urol. 2003 Oct;170(4 Pt 2):1681-5; discussion 1685
pubmed: 14501691
J Urol. 2002 Oct;168(4 Pt 2):1841-3; discussion 1843
pubmed: 12352372
Pediatr Surg Int. 2001;17(1):2-7
pubmed: 11294260
J Indian Assoc Pediatr Surg. 2019 Jan-Mar;24(1):31-35
pubmed: 30686885
J Pediatr Urol. 2011 Apr;7(2):203-8
pubmed: 20537589
BJU Int. 2001 Aug;88(3):263-7
pubmed: 11488743
J Urol. 2003 Oct;170(4 Pt 2):1514-5; discussion 1516-7
pubmed: 14501648
J Urol. 2006 Apr;175(4):1214-20
pubmed: 16515962
J Urol. 2004 Aug;172(2):706-11; discussion 711
pubmed: 15247767
BJU Int. 2005 Jul;96(1):140-3
pubmed: 15963137
J Urol. 2006 Jul;176(1):303-5
pubmed: 16753429
Br J Urol. 1988 Jul;62(1):59-62
pubmed: 3408870
J Indian Assoc Pediatr Surg. 2010 Jul;15(3):80-6
pubmed: 21124660
Adv Chronic Kidney Dis. 2017 Nov;24(6):348-356
pubmed: 29229165
AJR Am J Roentgenol. 1995 May;164(5):1233-5
pubmed: 7717237
Br J Urol. 1973 Aug;45(4):395-403
pubmed: 4729888
J Urol. 2002 Jan;167(1):291-7
pubmed: 11743343
BJU Int. 2003 Oct;92 Suppl 1:38-41
pubmed: 12969008
J Indian Assoc Pediatr Surg. 2010 Jul;15(3):79
pubmed: 21124659
Biomed Res Int. 2014;2014:906921
pubmed: 24877147
J Indian Assoc Pediatr Surg. 2013 Oct;18(4):143-6
pubmed: 24347867
J Urol. 1996 May;155(5):1730-4
pubmed: 8627873
J Urol. 1997 Mar;157(3):984-8
pubmed: 9072631