title: Posterior urethral valves: long-term outcome.
abstract: Posterior urethral valves represent the most common cause of bladder outlet obstruction in infancy that impairs renal and bladder function. Long-term outcome of patients with previous PUV is evaluated. Patients over 18 years of age, treated from 1982 to 1995 before the age of 3 years were considered. Previous surgery, renal function, bladder activity, urinary incontinence, and fertility/sexual activity were evaluated. Clinical interview, creatinine clearance, uroflowmetry with ultrasound post-void urine residue, and self-administered questionnaire were recorded. Out of 45 identified records, 24 patients (53.3%) accepted to be enrolled (age 18-34 years, mean 23 years). The mean follow-up was 19.5 years (16-30 years). Out of the 21 excluded patients, 20 did not reply to the clinical interview and 1 died at age of 6 years. All the 24 patients had early endoscopic section of PUV; nine also received transient ureterocutaneostomy or vesicostomy. Ureteroneocystostomy was performed in five patients and ureterocystoplasty with unilateral nephrectomy in two. At follow-up chronic renal failure was detected in 13 patients (54.1%) and 9 (37.5%) had arterial hypertension. End-stage renal disease developed in five patients (20.8%): three had successful renal transplantation and two were in dialysis. Lower urinary tract symptoms were present in seven patients (29.1%). No significant fertility deficit and sexual dysfunction were observed in 23 patients, while 1 patient was azoospermic. No paternity was reported so far. Long-term outcome of patients with previously treated PUV is mandatory. Kidney, bladder, and sexual functions should be monitored till adulthood to verify any modified behaviour.
authors: Division of Pediatric Urology, Department of Nephrology-Urology, Bambino Gesù Children's Hospital and Research Institute, Piazza S. Onofrio, 4, 00165, Rome, Italy. paolo.caione@opbg.net
authors: Paolo
authors: P
authors: Caione
authors: Simona Gerocarni
authors: SG
authors: Nappo
mesh_terms: D000293:Adolescent; D000328:Adult; D002675:Child, Preschool; D003266:Continuity of Patient Care; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007248:Infertility, Male / Q000209:etiology; D007558:Italy; D007676:Kidney Failure, Chronic / Q000209:etiology; D008297:Male; D011247:Pregnancy; D011296:Prenatal Diagnosis; D012189:Retrospective Studies; D012735:Sexual Dysfunction, Physiological / Q000209:etiology; D016019:Survival Analysis; D016896:Treatment Outcome; D014525:Urethral Stricture / Q000150:complications / Q000151:congenital / Q000175:diagnosis / Q000601:surgery*; D001748:Urinary Bladder Neck Obstruction / Q000150:complications / Q000151:congenital / Q000175:diagnosis / Q000601:surgery*; D014570:Urologic Diseases / Q000209:etiology* / Q000517:prevention & control