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Can concomitant bladder neck incision and primary valve ablation reduce early re-admission rate and secondary intervention?

OBJECTIVE: To assess the effect of bladder neck morphology and its incision (BNI) in patients with posterior urethral valve (PUV) on early reintervention rate. PATIENTS AND METHODS: Infants undergoing PUV ablation (PVA) before 24 months of age and had at least 18 months of follow-up, were categorize...

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Detalles Bibliográficos
Autores principales: Abdelhalim, Ahmed, Hashem, Abdelwahab, Abouelenein, Ebrahim E., Atwa, Ahmed M., Soltan, Mohamed, Hafez, Ashraf T., Dawaba, Mohamed S., Helmy, Tamer E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Sociedade Brasileira de Urologia 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9060171/
https://www.ncbi.nlm.nih.gov/pubmed/35168311
http://dx.doi.org/10.1590/S1677-5538.IBJU.2021.0383
Descripción
Sumario:OBJECTIVE: To assess the effect of bladder neck morphology and its incision (BNI) in patients with posterior urethral valve (PUV) on early reintervention rate. PATIENTS AND METHODS: Infants undergoing PUV ablation (PVA) before 24 months of age and had at least 18 months of follow-up, were categorized into three groups according to the bladder neck appearance on baseline radiological and endoscopic examination: group 1; normal bladder neck underwent PVA, group 2; high bladder neck underwent PVA plus BNI, group 3; high bladder neck underwent PVA only. Early reintervention was defined as the need for check cystoscopy because of persistent renal function deterioration, worsening hydronephrosis and/or unsatisfactory VCUG improvement during the 1st six months post primary PVA. RESULTS: Between 2000 and 2017, a total of 114 patients underwent PVA and met the study criteria with a median follow-up of 58 (18-230) months. For group 1, 16 (22.9%) patients needed readmission. Check cystoscopy was free and no further intervention was performed in 5(7.5%) and re-ablation was performed in 11(15.7%) patients. For group 2, 3(14.3%) patients needed reintervention. Re-ablation and re-ablation plus BNI were performed in 1(4.8%) and 2(9.5%), respectively. For group 3, cystoscopy was free in 1(4.3%), re-ablation and re-ablation plus BNI were performed 2(8.7%) and 1(4.3%), respectively. There were no significant differences in the re-admission and re-intervention rates among the three study groups (p=0.65 and p=0.50, respectively). CONCLUSION: In morphologically high bladder neck associated PUV, concomitant BNI with PVA doesn’t reduce early re-intervention rate.