Wang Chaoxu,Zhang Weiping,Song Hongcheng,et al.Outcome of vesicoureteral reflux in patients with posterior urethral valves after primary valve ablation[J].Journal of Clinical Pediatric Surgery,,18():225-228.[doi:10.3969/j.issn.1671-6353.2019.03.013]
Outcome of vesicoureteral reflux in patients with posterior urethral valves after primary valve ablation
- CLC:
- R726.9;R699.6;R693
- Abstract:
- Objective To summarize our institutional experience in the management of posterior urethral valves and analyze the effect of primary valve ablation on vesicoureteral reflux and hydronephrosis.Methods We retrospectively analyzed the records of 19 selected boys diagnosed with vesicoureteral reflux with posterior urethral valve from January 2010 to January 2016.The 19 patients were aged 6 months to 182 months[(27.4±7.2) months].The patitents who had reflux at presentation,which were unilateral in 12 and bilateral in 7 patients.They were taken ultrasonography detecting hydronephrosis and voiding cystoureterography detecting vesicoureteral reflux at baseline,6 months and 12 months after valve ablation.Results Nineteen patients were followed up for 13 months to 84 months[(38.8±9.8) months].The diameter of the pelvis and ureter decreased and the renal parenchymal thickness increased 1 year after valve ablation (P<0.05).Reflux resolved after relief of obstruction in 13/19 (68.4%) patients.The reflux more often resolved in low-grade reflux than high group (40% of units versus 36.6%) 6 months after operation and (53.5% of units versus 45.4%).Persistent vesicoureteral reflux was detected in 6 boys and postoperative urodynamic study was underwent,detrusor instability was detected in 4 boys and 3 developed low compliance.Conclusion Primary valve ablation can lead to improvement in VUR and hydronephrosis.More attention should be paid to bladder function of patients with persist VUR after valve ablation.
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Memo
收稿日期:2017-11-20。
基金项目:北京市医院管理局“登峰”人才培养计划（编号：DFL20151102）；北京市医院管理局“扬帆计划”（编号：ZYLX201709）
通讯作者:张潍平,Email:zhangwpp@163.com