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Related Experiment Videos

Temporary high diversion for posterior urethral valves.

A Liard1, E Seguier-Lipszyc, P Mitrofanoff

  • 1Department of Pediatric Surgery, Rouen University Hospital, Rouen, France.

The Journal of Urology
|June 7, 2000
PubMed
Summary

Temporary high diversion using Sober-en-T ureterostomy may improve kidney function in boys with severe posterior urethral valves without harming bladder function. This procedure offers a safe option for managing this condition.

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Area of Science:

  • Pediatric Urology
  • Nephrology
  • Surgical Innovation

Background:

  • Posterior urethral valves (PUV) are a common cause of bladder outlet obstruction in male infants.
  • The role of temporary high diversion in managing severe PUV remains a subject of debate among clinicians.
  • Concerns exist regarding potential negative impacts on renal function and bladder development.

Purpose of the Study:

  • To evaluate the efficacy and safety of temporary high diversion via Sober-en-T ureterostomy in boys with posterior urethral valves.
  • To address the controversy surrounding the benefits of high diversion for renal function and bladder health.
  • To investigate whether Sober-en-T ureterostomy impacts bladder function negatively.

Main Methods:

  • Retrospective evaluation of 17 boys with posterior urethral valves who underwent Sober-en-T ureterostomy.

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  • Assessment of upper urinary tract decompression and bladder function post-diversion.
  • Monitoring of renal function, including creatinine levels, before and after diversion.

    • Main Results:

    • Sober-en-T ureterostomy provided immediate decompression of the upper urinary tract.
    • Bladder function remained good, with no observed deleterious effects from the diversion.
    • Rapid improvement in creatinine levels was noted in all cases following diversion, suggesting potential renal benefit.
    • Distinction made between Sober-en-T diversion (preserving bladder cycling) and loop diversion (defunctionalizing the bladder).

    Conclusions:

    • Temporary high diversion, specifically Sober-en-T ureterostomy, is recommended for severe cases of posterior urethral valves.
    • This procedure may offer potential improvements in renal function.
    • Sober-en-T ureterostomy does not appear to damage bladder function and preserves its cycling ability.