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Follow up in posterior urethral valve after primary valve fulguration or diversion with fulguration with special references to urodynamic studies

Lalit Kumar, Rahul Tiwari, Amit Sandhu, Sakshi Agarwal, Bajrang Tak.




Abstract

Background: Follow up of posterior urethral valve patients is very crucial as it is commonest congenital obstruction of the lower urinary tract.

Objective: To evaluate outcome after surgery with special reference to urodynamic studies.

Materials and Methods: Study has been carried out retrospectively. Fifty cases of PUV of age ≥3 years were included in the study between the time period of July 2010 to June 2012. Long term outcome had been evaluated by renal profile, MCU, and UDS regarding bladder dysfunction. In most of the cases the initial presentation data were collected retrospectively at the time of follow up. At that time UDS was performed if there was no contraindication. 50 cases were divided into 2 groups. Group 1 included 18 patients which were managed only by primary valve fulguration while group 2 included 32 patients which required urinary diversion procedure.

Result: The mean value of serum creatinine in group 1 was 1.486±0.7646 mg/dl at the time of initial presentation and 0.8511±0.22721 mg/dl at the time of follow up while for group 2 it was 1.737±0.9734 mg/dl and 1.0913±0.41396 mg/dl, respectively. The mean value of PdetMax was 79.20±33.842 cm H2O in group1 and it was 51.14±28.141 cm H2O in group 2. Mean value of bladder compliance was 15.86±17.902 mL/cm H2O in group 1 and 6.26±3.605 mL/cm H2O in group 2. PdetMax and bladder compliance showed significantly better results in group 1 as p

Key words: Bladder, posterior urethral valve, urodynamic studies






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