Effects of abnormal micturition in boys with posterior urethral valves after valve ablation

Abstract

Objective To explore the effects of abnormal micturition in the prognosis of boys with posterior urethral valve (PUV) after valve ablation.Methods Retrospective analyses were conducted for the clinical data of 58 boys with a diagnosis of PUV during July 2002 to February 2012 after posterior urethral valve ablation.Also the clinical symptoms,imaging abnormalities and urine dynamic test results and its changes were recorded and analyzed.And they were divided into normal and abnormal micturition groups to analyze the age distribution,upper tract and urinary dynamics parameters.Results The postoperative symptoms included urinary incontinence (18/58; 31.0％),urinary tract infections (8/58; 13.8％),arduous & dribbling micturition (15/58; 25.9％),urinary frequency (4/58; 6.9％) and renal failure (3/58; 5.2％).Imaging examinations showed bilateral hydronephrosis (50/58; 86.2％) and countercultural reflux (20/58; 39.7％).Urine dynamic test showed different degree of abnormal urine dynamics (56/58; 96.6％),detrusor instability (n =16,27.6％),powerless Detrusor contractions (n =6,10.3 ％),residual urine volume ＞ 10 ml (n =25,43.1 ％) and abdominal pressure in urination (n=23,39.7％).The ages of micturition abnormal group were older and hydronephrosis in normal micturition group was less than abnormal micturition group.And the bladder ureter reflux ratio of micturition abnormal group was significantly higher than that of normal group.Bladder compliance and residual urine volume had obvious statistical significance.The maximum bladder capacity comparison and urine flow rate showed no obvious statistical difference between two groups.Conclusions There are many subsequent problems in boys with PUV after valve ablation.Abnormal micturition influences the prognosis.Urodynamic studies may reveal the existence and rate of bladder dvsfunction.For children with PUV,regular urodynamic studies should be performed to evaluate bladder function and prevent further damage to upper urinary tract so as to improve the prognosis. Key words: Urination disorders; Hydronephrosis; Urodynamics