342 / 492
S27-13
(P)
IN WHAT AGE CHILDREN TREATED FOR POSTERIOR URETHRAL VALVES BECOME
CONTINENT?
Seppo TASKINEN
1
, Jenni JALKANEN
2
and Jukka HEIKKILÄ
3
1) Helsinki University Central Hospital, Paediatric surgery, Helsinki, FINLAND - 2) Kuopio University Hospital, Paediatric
surgery, Kuopio, FINLAND - 3) Hyvinkää Hospital, Paediatric surgery, Hyvinkää, FINLAND
PURPOSE
To evaluate the age at which patients with PUV achieve continence and the factors contributing to this.
MATERIAL AND METHODS
Hospital records of consecutive 72 PUV patients treatedfrom 1990 to 2008 were reviewed. Continence was defined by
the absence of weekly wetting episodes.The age having gained daytime and nighttime continence was registered in the
patient files in 50 and 51 patients respectively. Patient characteristics were evaluated.
RESULTS
The patients achieved daytime and nighttime continence at the age of 5.36± 3.3 and 5.21± 3.0 years respectively. This
was later than in a recent national study with unselected childpopulation (2.3± 0.5 and 2.9± 1.2 years resp, p< 0.001).
Patients diagnosed at early age (antenatally or neonatally) stopped daytime wetting significantly later than those
diagnosed as older (5.9 vs. 4.1 years, p=0,019). The patients with abnormallyhigh s-creatinine values at the age of 5
years became continent at an older age compared to those with normal creatinine (daytime 6.0 vs. 4.1 years, p=0,055;
nighttime 5.5 vs. 3.7 years, p=0.032). The patients who had temporary ring -type supravesical diversion done primarily
did not differ from their counterparts without diversion in respect to the age of gaining continence. The patients who had
>10% residuals of the expected bladder volume at the age of 5-7 years had significantly higher s-creatinine values
(p=0,011).
CONCLUSIONS
Patients with posterior urethral valves achieve continence remarkably late. Delayed continence is especially prominent in
patients with early diagnosis and high serum creatinine values. Polyuria as a feature of renal injury may be involved.