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Related Experiment Videos

Long-term bladder dysfunction in boys with posterior urethral valves

C Pfister1, L Wagner, J N Dacher

  • 1Clinique Chirurgicale Infantile, C.H.U. Charles Nicolle, Rouen, France.

European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery ... [Et Al] = Zeitschrift Fur Kinderchirurgie
|August 1, 1996
PubMed
Summary

Posterior urethral valve (PUV) surgery in children can lead to urinary incontinence. Long-term urodynamic evaluation shows most patients achieve continence, with some requiring further treatment.

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Area of Science:

  • Pediatric Urology
  • Urology
  • Pediatric Surgery

Background:

  • Posterior urethral valve (PUV) is a congenital obstruction in the male urethra.
  • Early surgical intervention is crucial for managing PUV.
  • Long-term sequelae, particularly vesico-sphincteric dysfunction, require thorough investigation.

Purpose of the Study:

  • To assess the long-term vesico-sphincteric outcomes in children treated for PUV.
  • To evaluate the efficacy of urodynamic studies in identifying persistent incontinence.
  • To determine the impact of PUV on renal function and bladder compliance over time.

Main Methods:

  • Retrospective analysis of 60 children operated for PUV before age 5.
  • Long-term follow-up including pelvic ultrasonography, pressure-flow studies with EMG, and renal function tests.

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  • Urodynamic evaluation of incontinent patients to assess bladder and sphincter function.

    • Main Results:

    • 38 patients (63%) experienced early post-operative urinary incontinence.
    • Of 28 evaluable patients at 10-year follow-up, 22 (79%) achieved continence.
    • Incontinent patients showed uninhibited detrusor contractions; vesical compliance was generally normal. No detrusor-sphincter dyssynergy or urethral hypotonia found.

    Conclusions:

    • Long-term urodynamic evaluation in children treated for PUV is encouraging.
    • While many achieve continence, a subset requires further management for persistent incontinence.
    • Treatment strategies include medication, biofeedback, and consideration of artificial sphincters.