274 Retrospective Cohort Study of the Long-Term Outcome of Posterior Urethral Valve – A Single Centre Experience

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Abstract Aim Posterior Urethral Valves (PUV) are the most common cause of bladder outlet obstruction in male infants. Despite definitive management by endoscopic valve resection, some patients develop persistent bladder dysfunction and progressive chronic kidney disease (CKD). This study aims to evaluate the long-term complications of PUV, as well as evaluate bladder and renal dysfunction pre- and post-operatively. Method A retrospective review of all the patients who received PUV ablation between 2012 to 2016 in a tertiary paediatric urology centre. Data collected included demographics, laboratory and radiographic investigations, and surgical outcomes. The data were analysed with SPSS. Results Twenty-three patients were included in the study; antenatal diagnosis was made in 43.5% (n=10) with 56.5% (n=13) postnatally. Mean follow-up time was 7.1±2.3 years (4.8–9.4). Voiding dysfunction was the most common complication in later life (34.8%, n=8), followed by CKD (13.0%, n=3), kidney transplant (8.7%, n=2), hypertension (8.7%, n=2) and mortality (8.7%, n=2). There was a statistically significant difference (p=0.003) between pre- and post-operative creatinine values. 5 patients who had creatinine values postoperatively of >88.4μmol/L (21.7%) sustained poor renal outcomes. Radiologically, there was a significant improvement in the anteroposterior (AP) diameter of the renal pelvis and kidney growth based on current, post-operative and preoperative ultrasound (p<0.05). Nevertheless, there was no statistically significant improvement in ureteric dilatation. Conclusions Post PUV ablation, urinary incontinence and CKD remain the most substantial long-term outcome. Proactive multidisciplinary management with careful follow-up are essential to reduce the burden of the disease.