Title: Follow Up With Clinical Characteristics and Somatic Growth in Posterior Urethral Valve

Authors: Dr Lalit Kumar, Dr Rahul Tiwari, Dr Amit Sandhu, Dr Sakshi Agarwal, Dr Bajrang Tak, Dr Ashok Kumar, Dr Mahesh Joshi

 DOI:  http://dx.doi.org/10.18535/jmscr/v4i6.70

Abstract

Purpose- Follow up of PUV patients is very crucial. We analyzed the long term follow up in posterior urethral valves with clinical characteristics and somatic growth.

Materials and methods- Study has been carried out both retrospectively. Fifty cases of PUV of age ≥3 years were included in the study. 32 patients required urinary diversion procedure along with primary valve fulguration while 18 patients were managed only by primary valve fulguration. Fifty identical age matched children were selected as controls. In both case and control group somatic growth was recorded in 3 followups at 6 months interval.

Results- The mean weight and height at the time of initial presentation of study group was 9.40±7.81kg & 72.55±12.77cm and for control group 15.83±4.15kg & 86.35±13.05cm. In the 3rd follow up the mean weight and height of study group was 20.72±11.07kg &112.00±23.1cm and for control group 25.45±10.21kg & 114.25±24.22cm. The mean weight and height at the 3rd follow up in primary valve fulguration group was 22.78±14.858kg & 44.94±11.644 inch while in diversion with fulguration was 19.56±8.310kg & 44.72±7.787 inch.

Conclusions- Somatic growth remains significantly lower in PUV patients. Proper nutritional support is essential to achieve near normal somatic growth.

Manuscript Keywords- Posterior urethral valves; Urinary Diversion; Urinary tract infection

References

    

1.      Atwell JD. Posterior urethral valves in the British Isles: a multicenter B. A. P. S. review. J. Pediatr. Surg 1983; 18(1):70– 74.

2.      Hutton KA, Thomas DF, Arthur R J, Irving HC, Smith SE. Prenatally detected posterior urethral valves: is gestational age at detection a predictor of outcome? J Urol. 1994;152w(2 Pt 2):127129.

3.      Thomas DFM, Gordon AC. Management of prenatally diagnosed uropathies. Arch. Dis. Child. 1989; 64:58–63.

4.      Cromie WJ, Lee K, Houde K, Holmes L. Implications of prenatal ultrasound screening in the incidence of major genitourinary malformations. J Urol. 2001 May;165(5):1677-80.

5.      Hendren,W. H. Posterior urethral valves in boys. A broad clinical spectrum. J. Urol. 1971; 106(2):298–307.

6.      Dinneen MD, Duffy PG. Posterior urethral valves.Br. J. Urol. 1996; 78(2):275–281.

7.      Kim YH, Horowitz M, Combs AJ, Nitti VW, Borer J, Glassberg KI. Management of posterior urethral valves on the basis of urodynamic findings. J Urol 1997;158:10111016.

8.      Gangopadhyay An. The Experience of Managing Posterior Urethral Valve (PUV) over a Period of 22 Years : A Single Center Study. J Indian AssocPediatrSurg 2003; 8:133-139.

9.      Miguel L, Podesta, Ruarte A, Gargiulo C, Medel R, Castero R. Urodynamic Findings In Boys With Postcrior Urethral Valves After Treatment With Primary Valve Ablation or vesicostomy and Delayed Ablation. J Urol 2000; 171: 24092412.

10.  Ghanem MA, Nijman RJM. Longterm followup of bilateral high (sober) urinary diversion in patients with posterior urethral valves and its effect on bladder function. J Urolo 2005;173:1721–1724.

11.  Caione P, Nappo SG. Posterior urethral valves: Long-term outcome. PediatrSurg Int. 2011;27(10):1027–35.

12.  Young HH, Frontz WA, Baldwin JC. Congenital obstruction of the posterior urethra. J. Urol. 1919; 3:289-365.

13.  Garg SK, Abduurahman MB, Momoh JT, Hargreaves HM, Narayana P, Lawrie JH. Congenital posterior urethral valves:Problems of management in countries with limited facilities.Ann.Trop.Paediatr.1983 Dec;3(4):201-5.

14.  Pieretti RV. The mild end of the clinical spectrum of posterior urethral valves. J. Pediatr. Surg. 1993; 28(5):701–704.

15.  Mirshemirani A, Khaleghnejad A, Rouzrokh M, Sadeghi A, Mohajerzadeh L, Sharifian M. Posterior Urethral Valves; A single Center Experience.Iran J Pediatr 2013;23(5):531-535. 20.

16.  Otukesh H, Sharifiaghdas F, Hoseini R, Fereshtehnejad SM, Rabiee N, Kiaiee MF. Long-term upper and lower urinary tract functionsin children with posterior urethral valves. jpurol.2009.06.143-147

17.  Uthup S, Binitha R, Geetha S, Hema R, Kailas L. A follow-up study of children with posterior urethral valve.Indian J Nephrol. 2010;20(2):72–75.

18.  Narasimhan KL, Kaur B, Chowdhary SK, Bhalla A, Smaujh R, Rao KLN, Mahajan JK, Prospective Analysis of Renal function and Somatic growth in Neonatal Posterior Urethral valves. Eur J PediatrSurg 2002; 12:267-271.

19.  Nambirajan L, Bhatnagar V, Lal R, Agarwal S, Gupta AK, Mitra DK. Somatic and renal growth in boys treated for posterior urethral valves. J Indian AssocPediatrSurg 2004;9: 131-136.

20.  Krueger RP, Hardy BE, Churchill BM. Growth in boys with posterior urethral valves.Primary valve resection vs upper tract diversion.UrolClin N Am 1980; 7 (2): 265- 272.

Corresponding Author

Lalit Kumar

MCH Resident, Department of Urology, S P Medical College, Bikaner, Rajasthan (INDIA)

Address- Room Number 40, New PG Hostel, Near S P Medical College, Bikaner, Rajasthan (INDIA),

Pin code-334001

Email: This email address is being protected from spambots. You need JavaScript enabled to view it., Phone number- 7073567088