Keywords
Posterior urethral valves; Endoscopy; Urethrotome; Bladder dysfunction associated with PUV; Renal failure
Abstract
Introduction : Endoscopic incision is generally considered the definitive treatment for Posterior Urethral Valves (PUV). This study aims to describe our technique for endoscopic resection of PUV and the long-term outcomes of bladder function.
Patients and methods : We conducted a prospective study in the Pediatric Surgery Department at Albert Royer Children’s Hospital, Dakar, from January 1, 2020, to June 20, 2023. Thirty-two children with PUV underwent endoscopic treatment and were followed for at least six months. We assessed pre- and postoperative urinary diversion, age at PUV incision, bladder capacity, urinary incontinence, voiding disorders, bladder dysfunction, and renal failure.
Results : The mean age at treatment was 27.3 months (range: 1 day to 10 years); 65.6% were infants. Preoperative urinary diversion was performed in 62.5% of patients. Post-incision, transurethral catheterization averaged 49.9 hours. At a mean follow-up of 4.8 years, no patients reported dysuria; 90.5% experienced urinary incontinence, and 76.2% had urgency and frequent urination. Among those over 5 years old, 80% were suspected of bladder dysfunction. Three months post-resection, 90.6% had normal renal function. After an average of 16.7 months, 75% had elevated age-specific creatinine levels. Ultrasound showed improvement in 46.8%, stability in 28.1%, and worsening in 9.3%. Renal scintigraphy revealed pyelonephritic scarring in two patients; one had normal results.
Conclusion : Despite endoscopic incision, renal and bladder function outcomes in children with PUV remain unpredictable, especially with comorbid factors like delayed treatment, urinary diversions, and infections.
Citation
Ndoye NA, Keita NE, Cisse L, DIOUF C, Tall DM,et al. (2024) Prospective Evaluation of the Endoscopic Treatment of Posterior Urethral Valves in a Pediatric Hospital in Dakar. SM J Pediatr Surg 7: 5.