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Published on: January 7, 2019
Long-term outcome of posterior urethral valves ablation using the Mohan's urethral valvotome
1Department of Surgery, College of Medicine, University of Ibadan and University College Hospital, Ibadan, Nigeria.
Insights
Long-term follow-up is crucial for children treated for posterior urethral valves. Complications like UTIs and renal failure can arise years after valve ablation, necessitating extended monitoring.
Area of Science:
- Pediatric Urology
- Surgical Innovation
Background:
- Posterior urethral valves (PUV) represent the primary cause of mechanical infravesical obstruction in pediatric patients.
- The severity of PUV varies, and long-term complications can occur even after successful valve ablation.
Purpose of the Study:
- To evaluate the long-term outcomes of 26 children who underwent posterior urethral valves ablation using the Mohan's urethral valvotome.
- To assess the incidence of complications following PUV treatment at the University College Hospital, Ibadan.
Main Methods:
- A retrospective follow-up study of 26 children treated for PUV between January 1996 and December 2000.
- Patients were monitored regularly in the outpatient clinic for a period ranging from 18 months to five years post-ablation.
Main Results:
- Recurrent urinary tract infections (UTIs) were observed in 35% of cases.
- Long-term complications included acute renal failure (5%), chronic renal failure (15%), rickets, anemia, malnutrition, and urethral stricture.
Conclusions:
- Extended follow-up beyond the immediate post-ablation period is essential for children with posterior urethral valves.
- Proactive long-term monitoring can help identify and manage delayed complications effectively.
Context:
Posterior urethral valves are the most common cause of mechanical infravesical obstruction in children. The disorder has a broad spectrum of severity and the patients could develop complications on the long term, even after valves ablation.
Objective:
To report the result of the follow-up study of 26 children who had posterior urethral valves ablated with the Mohan's urethral valvotome at the University college hospital, Ibadan over a period of five years. STUDY DESIGN SETTING AND SUBJECTS: Children who had posterior urethral valves ablated with the Mohan's urethral valvotome at the UCH, Ibadan between January 1996 and December 2000 were followed up in the out patient clinic on a regular basis.
Results:
A total of 26 patients with posterior urethral valves had the valves ablated with the Mohan's urethral valvotome during the period of the study. The period of follow-up varied between 18 months and five years. Problems noticed on follow-up include recurrent urinary tract infections in 35% of the cases, acute and chronic renal failure in 5% and 15% respectively, rickets, anaemia, malnutrition and urethral stricture.
Conclusion:
Children who had posterior urethral valves ablated should be followed up much beyond the immediate post valve ablation period as complications could arise on the long term.
