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Related Experiment Videos

Vesicoureteric reflux with urethral valves.

J H Johnston

    British Journal of Urology
    |April 1, 1979
    PubMed
    Summary

    Bilateral vesicoureteric reflux in boys with posterior urethral valves indicates a poorer prognosis. Spontaneous reflux cure is often achievable, making surgical intervention unnecessary for preserving kidney function.

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    Area of Science:

    • Pediatric Urology
    • Nephrology

    Background:

    • Posterior urethral valves (PUV) are a common cause of bladder outlet obstruction in male infants.
    • Vesicoureteric reflux (VUR) is a frequent complication of PUV, impacting renal outcomes.
    • The prognostic significance of VUR in boys with PUV requires further elucidation.

    Purpose of the Study:

    • To investigate the incidence and prognostic significance of VUR in boys diagnosed with PUV.
    • To evaluate the impact of VUR on renal function and the necessity of surgical intervention.

    Main Methods:

    • Retrospective review of 66 boys diagnosed with posterior urethral valves.
    • Analysis of the relationship between VUR (unilateral, bilateral, none) and patient prognosis.
    • Assessment of spontaneous VUR resolution post-valve ablation and its correlation with renal function.

    Main Results:

    • Bilateral VUR at presentation is associated with a worse prognosis compared to unilateral or no VUR, irrespective of patient age.
    • VUR that does not resolve spontaneously after valve ablation often indicates a dysplastic or functionless kidney.
    • Spontaneous VUR cure is observed in kidneys with useful function post-valve ablation, suggesting surgical cure is unnecessary.

    Conclusions:

    • Endoscopic fulguration of PUV, infection control, and observation for spontaneous VUR cure are the primary strategies for preserving renal function.
    • Surgical correction of VUR is generally not indicated when the kidney retains useful function or if the ureter is severely dilated and dysplastic.
    • Early management focusing on valve ablation and managing infection is crucial for optimizing long-term renal outcomes in boys with PUV and VUR.

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