Long-term Follow Up of Posterior Urethral Valve Patients and Predictors of Outcome, Cairo University Specialized Pediatric Hospital
Shouman, A., Elgharably, M., El Fayoumy, H., El Rahman, S., Ghoneima, W., Abd El Wahab, M., Shoukry, A. (2022). Long-term Follow Up of Posterior Urethral Valve Patients and Predictors of Outcome, Cairo University Specialized Pediatric Hospital. EKB Journal Management System, 89(2), 7372-7377. doi: 10.21608/ejhm.2022.274799
Ahmed M Shouman; Mohamed AboulFotouh Elgharably; Hany El Fayoumy; SherifAbd El Rahman; Waleed Ghoneima; Mohamed Abd El Wahab; Ahmed Shoukry. "Long-term Follow Up of Posterior Urethral Valve Patients and Predictors of Outcome, Cairo University Specialized Pediatric Hospital". EKB Journal Management System, 89, 2, 2022, 7372-7377. doi: 10.21608/ejhm.2022.274799
Shouman, A., Elgharably, M., El Fayoumy, H., El Rahman, S., Ghoneima, W., Abd El Wahab, M., Shoukry, A. (2022). 'Long-term Follow Up of Posterior Urethral Valve Patients and Predictors of Outcome, Cairo University Specialized Pediatric Hospital', EKB Journal Management System, 89(2), pp. 7372-7377. doi: 10.21608/ejhm.2022.274799
Shouman, A., Elgharably, M., El Fayoumy, H., El Rahman, S., Ghoneima, W., Abd El Wahab, M., Shoukry, A. Long-term Follow Up of Posterior Urethral Valve Patients and Predictors of Outcome, Cairo University Specialized Pediatric Hospital. EKB Journal Management System, 2022; 89(2): 7372-7377. doi: 10.21608/ejhm.2022.274799

Long-term Follow Up of Posterior Urethral Valve Patients and Predictors of Outcome, Cairo University Specialized Pediatric Hospital

The Egyptian Journal of Hospital Medicine
Article 188, Volume 89, Issue 2, October 2022, Page 7372-7377  XML PDF (281.97 K)
Document Type: Original Article
DOI: 10.21608/ejhm.2022.274799
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Authors
Ahmed M Shouman; Mohamed AboulFotouh Elgharably email ; Hany El Fayoumy; SherifAbd El Rahman; Waleed Ghoneima; Mohamed Abd El Wahab; Ahmed Shoukry
Abstract
Background: Posterior urethral valves (PUVs) are reported to occur in 1/5000-8000 live births. It represents the most frequent cause of bladder outlet obstruction in children and is associated with significant morbidities and even mortality.
Objective:The aim of the current study is to record thelong-term follow up of posterior urethral valve (PUV) patients and the effect of different predictors on outcome.
Patients and methods:A total of30 boys with PUV initially presented between January 2010 and December 2018 and strictly fulfilled our follow up protocol. We collected their data retrospectively; the last follow-up data were recorded and analyzed.
Results:Median age at presentation was 6.3 monthsand mean age at last follow-up 5.67 ± 2.78 years, duration of follow up was 1.8-10 years. Lower urinary tract dysfunction (LUTD) was present in 19 boys (63%). 10 patients (33%) developed chronic renal failure at the last follow-up. Vesicoureteric reflux was a risk factor for occurrence of LUTD (p=0.007). Diurnal incontinence was a predictor for both upper and lower urinary tract dysfunction (p=0.011), (p=0.004) respectively. Mean value of Nadir serum creatinine was increased in patients with renal impairment (p < 0.001), makes it a good predictor of future renal function with a cut-off value of 0.75 mg/dl. With a cut-off value of 2.28, the posterior/anterior urethra ratio was a good predictor for the success of PUV ablation (p < 0.001). SWRD score > 4 statistically correlated with upper tract deterioration (p < 0.005) but not to LUTD.
Conclusions:Daytime dribbling and significant post voiding urine volumes were predictors of poor outcome. Nadir serum creatinine with a cut-off value of 0.75 mg/dl was a good predictor of future renal function. Also with a cut-off value of 2.28, the posterior/anterior urethra ratio was a good predictor for the success of PUV ablation.
Keywords
Posterior urethral valve; Vesicoureteric reflux; Valve fulguration; Vesicostomy; Follow-up; Cairo University
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