Is Vesicostomy Still a Contemporary Method of Managing Posterior Urethral Valves?

• Main Authors: Aybike Hofmann (Author), Maximilian Haider (Author), Alexander Cox (Author), Franziska Vauth (Author), Wolfgang H. Rösch (Author)
• Format: Book
• Published: MDPI AG, 2022-01-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.

Summary

In boys with posterior urethral valves (PUVs) the main treatment aim is to preserve long-term bladder and renal function. To determine the effectiveness of secondary vesicostomy in boys with PUVs, the medical records of 21 patients with PUV (2010-2019), divided into two groups (group I: valve ablation; group II: secondary vesicostomy), were reviewed regarding the course of serum creatinine, renal ultrasound, voiding cystourethrogram, urodynamics, postoperative complications, need of further surgery, and long-term solution. The median age of all patients at first follow-up was 11 (9-13) months and at last follow-up 64.5 (39.5-102.5) months. Despite a significant difference of the SWDR score (shape, wall, reflux, and diverticula) (<i>p</i> = 0.014), both groups showed no significant differences preoperatively. Postoperatively, serum creatinine (<i>p</i> = 0.024), grade of vesicoureteral reflux (<i>p</i> = 0.003), side of upper tract dilatation (<i>p</i> = 0.006), side of megaureter (<i>p</i> = 0.004), and SWDR score (<i>p</i> = 0.002) were significantly decreased in group II. Postoperative urodynamic measurements showed comparable results in both groups. Stoma complications were found in three (20%) patients (group II). Eight (53.3%) patients already received a closure of the vesicostomy. Seven out of eight (87.5%) patients were able to micturate spontaneously. Vesicostomy remains a reliable treatment option for boys with PUV to improve bladder function and avoid further damage to the urinary tract.

Item Description

10.3390/children9020138
2227-9067