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Does VURD syndrome impact voiding efficiency in posterior urethral valves?
Adree Khondker1, Priyank Yadav1, Jin K Kim2
1Division of Urology, The Hospital for Sick Children, Toronto, ON, Canada.
Journal of Pediatric Urology
|April 5, 2023
Summary
Vesicoureteral reflux with kidney dysplasia (VURD) syndrome does not protect boys with posterior urethral valve (PUV) from long-term bladder issues. This study found no significant difference in voiding efficiency or catheterization needs for boys with VURD syndrome.
Area of Science:
- Pediatric Urology
- Nephrology
- Developmental Biology
Background:
- Posterior urethral valve (PUV) is a common cause of bladder outlet obstruction in male infants.
- Vesicoureteral reflux with ipsilateral kidney dysplasia (VURD) syndrome is a recognized complication of PUV.
- The long-term impact of VURD syndrome on bladder outcomes in boys with PUV remains debated.
Purpose of the Study:
- To investigate the long-term bladder outcomes and voiding efficiency in boys with PUV.
- To determine if VURD syndrome confers a protective effect on bladder function in these patients.
Main Methods:
- Retrospective chart review of toilet-trained children with PUV (2000-2022).
- Patients stratified by VUR status and presence of VURD syndrome (high-grade VUR + ipsilateral kidney dysplasia).
- Outcomes assessed via uroflowmetry parameters and need for clean-intermittent catheterization (CIC).
Main Results:
- 101 patients with a median follow-up of 114 months were analyzed.
- Patients with VURD syndrome showed similar voiding efficiency and post-void residuals compared to other PUV patients.
- No significant difference in the risk of requiring CIC was observed between VURD syndrome patients and others (p=0.06).
Conclusions:
- VURD syndrome does not appear to offer protection against poorer bladder function in boys with PUV.
- Kidney dysplasia may have an independent association with bladder outcomes in PUV patients.
- Further research is needed to understand the independent role of kidney dysplasia on long-term bladder function.
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