Long-term upper and lower urinary tract functions in children with posterior urethral valves.
OBJECTIVE
Several factors have been identified as predictive of future renal function in children with posterior urethral valves (PUV). Our aim was to analyse upper and lower urinary tract outcome in patients with PUV, and determine any factors from the period of early management that were predictive of future renal function.


METHODS
The charts of 67 boys (mean age 2.4 years) diagnosed with PUV were reviewed. The most common presenting symptom was dribbling in 43.2% and UTI in 28.3%. Twenty-three (34.8%) patients developed end-stage renal disease aged 1-15 years. The mean time of renal survival was calculated as 7.8 (SEM=0.73) years.


RESULTS
Incontinence in patients over 5 years old, lower urinary tract dysfunction, serum creatinine level in first year or at the time of diagnosis, and presence of vesicoureteral reflux and high-grade bilateral reflux were significant risk factors for occurrence of renal failure in the future. Lower tract dysfunction was seen in 58.6% of patients. Postnatal diagnosis and presence of high-grade reflux were significant risk factors for the future occurrence of lower urinary tract dysfunction.


CONCLUSIONS
It is important to recognize that PUV have consequences not only during childhood or before treatment, but also during or after the treatment period. Long-term assessment and follow-up of upper and lower urinary tract functions after valve ablation is necessary.
Otukesh
Hasan
H
Urology and Nephrology Research Center, Shaheed Beheshti University of Medical Science, Labbafi Nejad Hospital, Ali Asghar Children's Hospital, Tehran, Iran. hasanotukesh@yahoo.com
Sharifiaghdas
Farzaneh
F
Hoseini
Rozita
R
Fereshtehnejad
Seyed-Mohammad
SM
Rabiee
Neda
N
Kiaiee
Mahdieh Fotooch
MF
Javadi
Ramila
R
Mojtahedzadeh
Mona
M
Simfroosh
Naser
N
Basiri
Abbas
A
Hooman
Nakysa
N
Nasiri
Javad
J
Delshad
Salahedin
S
Farhood
Pirrooz
P
D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D002648:Child; D002675:Child, Preschool; D003404:Creatinine / Q000097:blood; D006801:Humans; D007223:Infant; D007674:Kidney Diseases / Q000209:etiology*; D008297:Male; D012372:ROC Curve; D051437:Renal Insufficiency / Q000209:etiology; D012307:Risk Factors; D012680:Sensitivity and Specificity; D016019:Survival Analysis; D014521:Urethra / Q000002:abnormalities* / Q000601:surgery; D014555:Urination Disorders / Q000209:etiology*
D015415:Biomarkers; D003404:Creatinine