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- W2020691107 abstract "No AccessJournal of UrologyPediatric Urology1 May 1996The Long-Term Outcome of Posterior Urethral Valves Treated with Primary Valve Ablation and Observation Grahame H.H. Smith, Douglas A. Canning, Seth L. Schulman, Howard M. Snyder, and John W. Duckett Grahame H.H. SmithGrahame H.H. Smith More articles by this author , Douglas A. CanningDouglas A. Canning More articles by this author , Seth L. SchulmanSeth L. Schulman More articles by this author , Howard M. SnyderHoward M. Snyder More articles by this author , and John W. DuckettJohn W. Duckett More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)66186-XAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We believe that primary valve ablation with observation is the preferred management for posterior urethral valves. However, debate continues as to the role of high diversion. We examined the long-term outcome of a large series of patients treated with primary valve ablation, and compared it to the outcome of high diversion and vesicostomy. Materials and Methods: We reviewed the records of 100 patients treated with primary valve ablation (74 percent), vesicostomy (13 percent) or high diversion (9 percent) before 1985. Median followup was 11.2 years. Results: Overall 13 percent of our patients had end stage renal disease by age 15 years. Three patients initially treated with valve ablation and 3 initially treated with vesicostomy later underwent high diversion but none benefited from the secondary procedure. Four patients initially treated with valve ablation subsequently underwent vesicostomy but only 1 benefited. Bladder storage capacity was well preserved. Diurnal urinary continence developed in 46 percent of patients at age 10 years and only 1 remained incontinent after age 20 years. One patient with diversion who awaits transplantation had a small contracted bladder. Recent urodynamic studies in 10 cases of delayed urinary continence have not shown decreased bladder compliance or capacity. Kaplan-Meier analysis of outcomes of the different treatments indicated no statistical difference in patient age at end stage renal disease development. However, comparing the number of surgical procedures in the different treatment groups revealed a significant increase in the amount of surgery in infants with diversion. Our results were equivalent to those of the best published series, many of which strongly advocate high diversion. Conclusions: By avoiding diversion in most cases bladder function is preserved and the need for bladder augmentation is decreased. References 1 : Current management of posterior urethral valves. Urol. Clin. N. Amer1974; 1: 471. Google Scholar 2 : Growth in boys and posterior urethral valves. Primary valve resection vs. upper tract diversion. Urol. 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Volume 155Issue 5May 1996Page: 1730-1734 Advertisement Copyright & Permissions© 1996 by American Urological Association, Inc.MetricsAuthor Information Grahame H.H. Smith More articles by this author Douglas A. Canning More articles by this author Seth L. Schulman More articles by this author Howard M. Snyder More articles by this author John W. Duckett More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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- W2020691107 title "The Long-Term Outcome of Posterior Urethral Valves Treated with Primary Valve Ablation and Observation" @default.
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