Concomitant Bladder Neck Incision in Patients with Posterior Urethral Valve and Blad-der Neck Hypertrophy: Short-term...

Area of Science:

• Pediatric Urology
• Surgical Outcomes
• Urinary Tract Abnormalities

Background:

• Posterior urethral valves (PUV) are a common cause of bladder outlet obstruction in male infants.
• Concomitant bladder neck incision (BNI) with valve ablation (VA) has been proposed to improve outcomes.
• This study evaluates the short-term efficacy of combined BNI and VA.

Purpose of the Study:

• To compare the short-term reoperation rates of VA alone versus combined BNI and VA in patients with PUV.
• To assess secondary outcomes including renal function, urinary tract infections (UTI), hydronephrosis, and vesicoureteral reflux (VUR).

Main Methods:

• Randomized controlled trial comparing VA only versus VA with concomitant BNI.
• Patients with PUV and bladder neck hypertrophy were included.
• Primary endpoint was surgical reoperation within one year; secondary endpoints included renal function, UTI, hydronephrosis, and VUR at one year.

Main Results:

• Reoperation rates were similar between groups (15.2% VA alone vs. 10% BNI+VA).
• No significant differences in febrile UTI rates or estimated glomerular filtration rate (eGFR) at follow-up.
• A trend towards improved hydronephrosis resolution was observed in the BNI+VA group (55% vs. 40.9%).

Conclusions:

• Concomitant BNI with VA does not reduce short-term reoperation rates compared to VA alone for PUV.
• Upper urinary tract outcomes, including renal function and UTI rates, were comparable between the two groups.
• Further investigation may be needed for long-term efficacy and specific patient subgroups.