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ICCS S4-9
(P)
LONG TERM OUTCOME OF RENAL AND VOIDING FUNCTION OF PATIENTS WITH
POSTERIOR URETHRAL VALVE WHO UNDERWENT SURGICAL INTERVENTION.
Sang Hoon SONG
1
, Chanwoo LEE
1
, Jaeyoon JUNG
1
, Won Yeol CHO
2
and Kun Suk KIM
1
1) Asan Medical Center, University of Ulsan College of Medicine, Department of Urology, Seoul, KOREA (REPUBLIC OF) -
2) Dong-A University Medical Center, Seoul, KOREA (REPUBLIC OF)
PURPOSE
We investigated differences in long-term renal and voiding function according to the surgery performed during the
prenatal and neonatal period.
MATERIAL AND METHODS
We retrospectively analyzed 28 patients treated for posterior urethral valves. We classified patients according to
whether fetal intervention was performed and the primary surgical treatment, namely, primary valve excision or
vesicostomy. Renal function was assessed by determining the serum creatinine concentration. Decreased bladder
capacity was defined as maximum bladder capacity lower than 65% of the age-related calculated bladder capacity.
RESULTS
The mean gestational age at birth was 34.2 (28–40) weeks and the median follow-up period was 50 (4–214) months. In
total, 12 out of 28 patients (42%) underwent fetal intervention. Patients who underwent fetal intervention had
significantly higher serum creatinine concentrations than patients who did not (2.04 ± 1.51 mg/L vs. 1.17 ± 0.76 mg/L,
p = 0.046). Patients who underwent vesicostomy had higher preoperative serum creatinine concentrations than patients
who underwent endoscopic resection (2.08 ± 1.34 mg/L vs. 0.86 ± 0.71 mg/L, p = 0.014); however, postoperative
serum creatinine concentrations, which were measured at the final follow-up, did not significantly differ between these
two groups of patients (0.9 ± 1.4 mg/L vs. 0.3 ± 0.1 mg/L, p = 0.252). Five patients (50%) in the fetal intervention
group, three patients (21%) in the non-treatment group, four patients (33%) in the vesicostomy group, and three
patients (27%) in the primary endoscopic valve excision group had decreased bladder capacity. All patients were able to
void freely, with the exception of one patient (4%) who underwent dialysis and one patient (4%) who required self-
catheterization.
CONCLUSIONS
Neither fetal intervention nor vesicostomy decreased renal function and bladder capacity in long-term follow-up.