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Related Experiment Videos

Bladder dysfunction as a prognostic factor in patients with posterior urethral valves.

P Lopez Pereira1, M J Martinez Urrutia, L Espinosa

  • 1Department of Paediatric Urology, University Hospital La Paz, Madrid, Spain. ejaureguizar@hulp.insalud.es

BJU International
|July 23, 2002
PubMed
Summary

Bladder dysfunction significantly impacts long-term kidney health in boys with posterior urethral valves (PUV). Poor bladder compliance and myogenic failure are linked to worse outcomes, while bladder instability shows a lower incidence of renal failure.

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Area of Science:

  • Pediatric Urology
  • Nephrology
  • Urodynamics

Background:

  • Posterior urethral valves (PUV) are a common cause of bladder outlet obstruction in male infants.
  • Bladder dysfunction is a known complication of PUV, potentially impacting upper urinary tract status.
  • Long-term renal function in boys with PUV is influenced by various factors, including bladder behavior.

Purpose of the Study:

  • To determine the relationship between different types of bladder dysfunction and long-term renal function in boys diagnosed with PUV.
  • To identify specific urodynamic patterns associated with renal impairment in this patient cohort.

Main Methods:

  • Retrospective assessment of renal and bladder function in 59 boys with PUV.
  • Inclusion criteria: mean age 10 years (range 5-17), minimum 4-year follow-up, and at least two urodynamic studies.

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  • Categorization of patients based on renal function (normal vs. end-stage renal disease - ESRD) and bladder behavior (normal vs. dysfunctional).

    • Main Results:

    • 58% of boys with PUV exhibited some form of bladder dysfunction.
    • Among patients with ESRD (22/59), 68% had abnormal bladder behavior, compared to 51% in those with normal renal function.
    • Poor bladder compliance was the most frequent urodynamic pattern in ESRD (53%), associated with earlier onset of renal failure. Bladder instability was less common in ESRD and linked to lower renal failure incidence.

    Conclusions:

    • Bladder dysfunction is a critical prognostic factor for renal failure in boys with PUV.
    • Poor bladder compliance and myogenic failure represent high-risk urodynamic patterns for adverse renal outcomes.
    • Bladder instability appears to be associated with a more favorable renal prognosis in the context of PUV.