Real-Time Ultrasound-Guided Transurethral Incision for Posterior Urethral Valves.

Area of Science:

• Pediatric Urology
• Minimally Invasive Surgery
• Diagnostic Imaging

Background:

• Transurethral incision (TUI) is a standard treatment for posterior urethral valves (PUV) in children.
• A lack of standardized intraoperative methods exists for assessing TUI efficacy.
• Real-time ultrasound guidance (RUG-TUI) is proposed to enhance TUI procedures.

Purpose of the Study:

• To develop and evaluate a novel real-time ultrasound-guided transurethral incision (RUG-TUI) technique.
• To assess the feasibility and efficacy of RUG-TUI in pediatric patients with posterior urethral valves (PUV).

Main Methods:

• A retrospective feasibility study compared RUG-TUI with standard TUI in children with PUV.
• Transperineal linear ultrasound probe provided longitudinal urethral imaging.
• Key metrics included postoperative gross hematuria duration and urethral diameter ratio (E/C ratio).

Main Results:

• RUG-TUI group showed a significantly shorter duration of postoperative gross hematuria (p = 0.049).
• Significant improvement in urethral diameter ratio (E/C ratio) was observed post-RUG-TUI (p < 0.0001).
• No intraoperative bleeding or sphincter damage was reported in the RUG-TUI group.

Conclusions:

• RUG-TUI allows real-time visualization of urethral anatomy during PUV treatment.
• The technique facilitates assessment of the relationship between urethral stenosis and the external sphincter.
• RUG-TUI shows potential for improving intraoperative evaluation and patient outcomes in PUV management.