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Anatomy of the Genitourinary System II: Bladder and Urethra01:19

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Evaluation of Biomaterials for Bladder Augmentation using Cystometric Analyses in Various Rodent Models
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Long-term bladder outcomes using a prescriber pattern scoring system for posterior urethral valves.

N M Haney1, T Sholklapper2, C Crigger1

  • 1Jeffs Division of Pediatric Urology, Charlotte Bloomberg Children's Hospital, Johns Hopkins Medicine, Baltimore, MD, USA.

Journal of Pediatric Urology
|April 23, 2024
PubMed
Summary

Posterior urethral valve (PUV) patients treated with valve ablation (VA) or diversion (VES/CU) showed similar long-term bladder outcomes and progression to end-stage bladder. Retention issues were more common than incontinence across all treatments.

Keywords:
Lower urinary tract symptomsPosterior urethral valvesValve ablationVesicostomy

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Area of Science:

  • Pediatric Urology
  • Voiding Dysfunction
  • Bladder Reconstruction

Background:

  • Posterior urethral valves (PUV) require urinary drainage via valve ablation (VA) or diversion (vesicostomy/cutaneous ureterostomy).
  • Long-term bladder function and voiding symptoms after PUV treatment remain incompletely understood.
  • Characterization of voiding symptomatology after diversion reversal is limited.

Purpose of the Study:

  • To assess physician treatment patterns for retention and incontinence in PUV patients.
  • To compare outcomes between primary valve ablation (VA) and diversion (VES/CU).
  • To determine progression rates to bladder augmentation (end-stage bladder).

Main Methods:

  • Retrospective cohort study of 76 PUV patients (age 5-40).
  • Retention and Incontinence Scores calculated based on specific clinical parameters.
  • Severe symptomatology defined by score thresholds; end-stage bladder (ESB) by need for augmentation.

Main Results:

  • No significant difference in severe retention or incontinence treatment patterns between VA and VES/CU groups.
  • Similar rates of progression to ESB (9.4% VA vs. 17.4% VES/CU).
  • Retention symptomatology treatment was more common than incontinence treatment overall.

Conclusions:

  • Long-term bladder outcomes and progression to ESB are similar regardless of primary PUV intervention (VA vs. VES/CU).
  • VES/CU patients responded similarly to conservative treatments as VA patients.
  • Bladder outcomes in this cohort were not associated with the type of urinary diversion used.