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Abstract
Abstract Title
OUTCOME OF BOYS WITH POSTERIOR URETHRAL VALVES FROM A SINGLE TERTIARY HOSPITAL IN SINGAPORE
Presentation Type
Non-Moderated Poster Abstract
Manuscript Type
Clinical Research
Abstract Category *
Pediatric Urology
Author's Information
Number of Authors (including submitting/presenting author) *
1
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Country
Singapore
Co-author 1
ming tow chan chanmingtow@hotmail.com national university hospital, singapore urology singapore Singapore *
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Abstract Content
Introduction
Posterior urethral valve (PUV) is the most common congenital cause of bladder outflow obstruction in male infants. Despite timely treatment, renal damage can still occur in the long-term leading to chronic kidney disease (CKD).
Materials and Methods
A retrospective review of all PUV patients in a single tertiary institution between April 1998 - July 2019 was conducted to analyse their presentations, management, and outcomes. Long term renal function, radiologic scans and somatic growth were evaluated
Results
A total of 16 patients were included in this study. Two patients who defaulted all follow-ups were excluded. Seven patients (43.7%) presented in the antenatal period; four patients (25%) presented in the neonatal period; and five patients (31.3%) presented in the post-neonatal period. Primary transurethral fulguration of valves was done in 13 patients, while three had vesicostomies as the primary procedure. Three patients had associated anterior urethral valves (AUV), which were treated endoscopically. Nine boys had additional procedures for diversion and undiversion, VUR, non-functioning kidney and clean intermittent catheterisation. Ten patients had urodynamic studies performed, of which eight patients received anticholinergic therapy. 11 patients had DMSA scans, of which three patients had a normal study and eight patients showed unilateral reduced function. Four patients were diagnosed with CKD on long-term follow-up duration over 5 years. All patients were shown to have good somatic growth.
Conclusions
Patients with PUV can suffer from complications despite primary treatment. In our small cohort, a quarter of our patients developed CKD on follow-up. Thus, patients need long-term follow up to optimize bladder and renal function.
Keywords
posterior urethral valves (PUV); chronic kidney disease (CKD); vesico-ureteric reflux (VUR); bladder outflow obstruction; hydroureteronephrosis (HUN); transurethral fulguration
Figure 1
https://storage.unitedwebnetwork.com/files/1237/a80d3d492a8892ae31a2daaf6770ad7b.png
Figure 1 Caption
Micturating cystourethrogram showing a small capacity bladder, with a large posterior urethra. There is Grade 5 reflux into a large dilated ureter.
Figure 2
https://storage.unitedwebnetwork.com/files/1237/0f1f3c9f67ad02ec7c1569f13b0cbaf4.png
Figure 2 Caption
Contrast antegrade cysto-urethrogram of patient with PUV, AUV and on a vesicostomy through which dye was injected into the bladder. This was done after fulguration of PUV and hence the demarcation of the junction between posterior and anterior urethr
Figure 3
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2221
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