MP53-13 DOES THE PRESENCE OF PRESSURE "POP-OFFS" IMPACT VOIDING EFFICIENCY AND BLADDER OUTCOMES IN POSTERIOR URETHRAL VALVES?

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP53-13 DOES THE PRESENCE OF PRESSURE "POP-OFFS" IMPACT VOIDING EFFICIENCY AND BLADDER OUTCOMES IN POSTERIOR URETHRAL VALVES? Adree Khondker, Priyank Yadav, Jin Kyu Kim, Michael Chua, Natasha Brownrigg, Juliane Richter, Joana Dos Santos, Armando Lorenzo, and Mandy Rickard Adree KhondkerAdree Khondker More articles by this author , Priyank YadavPriyank Yadav More articles by this author , Jin Kyu KimJin Kyu Kim More articles by this author , Michael ChuaMichael Chua More articles by this author , Natasha BrownriggNatasha Brownrigg More articles by this author , Juliane RichterJuliane Richter More articles by this author , Joana Dos SantosJoana Dos Santos More articles by this author , Armando LorenzoArmando Lorenzo More articles by this author , and Mandy RickardMandy Rickard More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003301.13AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The protective role of pressure pop-offs, consisting of vesicoureteral reflux (VUR) and ipsilateral kidney dysplasia, in posterior urethral valve (PUV) is controversial. While there has been significant emphasis on exploring the non-significant association between “pop-offs” and kidney function, there is paucity of data on the impact of this mechanism on bladder function. Here, we analyzed this association by examining the role of pressure pop-offs on long-term bladder outcomes in PUV patients. METHODS: A retrospective chart review was conducted for toilet-trained children with PUV managed at our institution between 2000 and 2022, only excluding cases without recorded uroflowmetry studies. Patients were stratified by the presence of pressure pop-offs (high-grade VUR+ipsilateral kidney dysplasia). Outcomes included uroflowmetry parameters and initiation of clean-intermittent catheterization (CIC). Survival analysis was conducted to calculate hazard ratios (HR). RESULTS: We identified a total of 101 patients who met study inclusion criteria, with a median follow-up of 114 months (IQR 67, 169). The median age of first and last uroflowmetry was 57 months (IQR 48, 82) and 120 months (IQR 89, 160), respectively. Patients with pressure pop-offs had similar flow velocity, post-void residuals, and bladder voiding efficiency to other PUV patients at last follow-up uroflowmetry. On survival analysis, patients with pressure pop-offs had no significant difference in risk of requiring CIC compared to patients without pop-offs (HR 1.92, p=0.06). Kidney dysplasia was independently associated with increased risk of CIC (HR 3.16, p=0.02) while VUR was not (HR 1.85, p=0.07). CONCLUSIONS: We show that boys with pressure pop-offs are not at higher risk of poorer voiding and intermittent catheterization than others with PUV. By extension, VURD syndrome does not confer protection against poorer bladder function. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e717 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Adree Khondker More articles by this author Priyank Yadav More articles by this author Jin Kyu Kim More articles by this author Michael Chua More articles by this author Natasha Brownrigg More articles by this author Juliane Richter More articles by this author Joana Dos Santos More articles by this author Armando Lorenzo More articles by this author Mandy Rickard More articles by this author Expand All Advertisement PDF downloadLoading ...