Incidence and Progress of Vesicoureteric Reflux after Primary Fulguration of Posterior Urethral Valves
Introduction: Posterior urethral valve (PUV) is the most frequent cause of urethral obstruction in male child. These lesions may result in lifelong disabilities with incontinence and decreased renal function despite optimal medical management. Primary fulguration without upper tract diversion is the preferred modality of treatment in most cases of PUV. Regular follow-up is needed to check completion of valve fulguration, renal function, status of hydronephrosis, vesicoureteric reflux (VUR), urinary tract infection (UTI), and bladder function.
Materials and Methods: An interventional study among 30 purposively selected patients of PUV was conducted from December 2009 to July 2011. Most of the patients presented with weak urinary stream, dribbling of urine, straining at micturition, UTI, and palpable bladder. All children were subjected to ultrasonography (USG), blood urea, serum creatinine, routine urine examination, and culture studies. Structured questionnaire was used to collect information regarding improvement or disappearance of VUR and renal functional status before and after primary fulguration of PUV.
Results: Ages ranged from 10 days to 14 years; 16 were between 1year and 14 years (53.3%), 11(36.7%) were infants, and the rest 03(10%) were neonates. Average serum creatinine levels were found gradually decreasing significantly (p < 0.01) in subsequent follow-ups. Average blood urea nitrogen (BUN) was also decreased significantly (p < 0.05). VUR was present in 63.3% cases. Non-VUR was found in 60% cases on right side and 50% cases on left side. On the third follow-up after 3 months it became 73.3% on right side and 63.3% on left side. Positive correlation found in Pearson correlation test about the changes of reflux grades before and after fulguration was significant (p < 0.001). It was significant on both left and right kidneys. Positive correlation found in Pearson correlation test about the changes of GFR before and after fulguration was also significant (p < 0.001). Collected data was cleaned, edited, and analyzed with the help of software SPSS window version 15.0.
Conclusion: VUR disappeared in some cases and decreased in majority of the cases by 3 months after adequate restoration of urethral patency. Renal function came to normal range in two thirds of the cases.
Bangladesh Journal of Endosurgery Vol.1(2) May 2013: 23-28
Authors of articles published in BJE retain the copyright of their articles and are free to reproduce and disseminate their work. A Copyright and License Agreement signed and dated by the corresponding author on behalf of all authors must be submitted with each manuscript submission.
Copyright Agreement Form
Bangladesh Journal of Endosurgery (BJE) copyright and license agreement:
Title of the Article:
In submitting a research article ('article') to Bangladesh Journal of Endosurgery (BJE) I certify that:
1. I am authorized by my co-authors to enter into these arrangements.
2. I warrant, on behalf of myself and my co-authors, that:
- the article is original, has not been formally published in any other peer-reviewed journal, is not under consideration by any other journal and does not infringe any existing copyright or any other third party rights;
- I am/we are the sole author(s) of the article and have full authority to enter into this agreement and in granting rights to BJE are not in breach of any other obligation. If the law requires that the article be published in the public domain, I/we will notify BJE at the time of submission upon which clauses 3 through 6 inclusive do not apply;
- the article contains nothing that is unlawful, libellous, or which would, if published, constitute a breach of contract or of confidence or of commitment given to secrecy;
- I/we have taken due care to ensure the integrity of the article. To my/our - and currently accepted scientific - knowledge all statements contained in it purporting to be facts are true and any formula or instruction contained in the article will not, if followed accurately, cause any injury, illness or damage to the user.
And I agree to the following license agreement:
BJE Open Access license agreement
Brief summary of the agreement
Anyone is free:
- to copy, distribute, and display the work;
- to make derivative works;
- to make commercial use of the work;
Under the following conditions: Attribution
- the original author must be given credit;
- for any reuse or distribution, it must be made clear to others what the license terms of this work are;
- any of these conditions can be waived if the authors gives permission.
Statutory fair use and other rights are in no way affected by the above.
Full BJE Open Access license agreement
(Identical to the 'Creative Commons Attribution License')
Authors Full Name: