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Controlled Outcomes for Achievement of Urinary Continence among Boys Treated for Posterior Urethral Valves

2016; Lippincott Williams & Wilkins; Volume: 196; Issue: 1 Linguagem: Inglês

10.1016/j.juro.2016.02.2968

1527-3792

Jenni Jalkanen, Jukka Heikkilä, Kristiina Kyrklund, Seppo Taskinen,

Urological Disorders and Treatments

No AccessJournal of UrologyPediatric Urology1 Jul 2016Controlled Outcomes for Achievement of Urinary Continence among Boys Treated for Posterior Urethral Valves Jenni Jalkanen, Jukka Heikkilä, Kristiina Kyrklund, and Seppo Taskinen Jenni JalkanenJenni Jalkanen Department of Pediatric Surgery, Kuopio University Hospital, Kuopio, Finland , Jukka HeikkiläJukka Heikkilä Department of Pediatric Surgery, Hyvinkää Hospital, Hospital District of Helsinki and Uusimaa, Hyvinkää, Finland , Kristiina KyrklundKristiina Kyrklund Department of Pediatric Surgery, Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland , and Seppo TaskinenSeppo Taskinen Department of Pediatric Surgery, Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.2968AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We evaluated the age at which boys with a history of posterior urethral valves after no or minimal anticholinergic medication achieve urinary continence and the factors contributing to continence. Materials and Methods: We reviewed the hospital records of all males treated for posterior urethral valves at a single institution between 1990 and 2008. Continence was considered to have been attained if no weekly wetting episodes occurred. We evaluated the influence of patient characteristics, including reduced kidney function and primary ring type ureteral stoma, on age at which continence was achieved. Results: A total of 76 patients were assessed. Achievement of daytime and nighttime urinary continence was markedly delayed in patients (mean ± SD age 5.5 ± 3.3 years and 5.4 ± 3.0 years, respectively) compared to the reference population (2.3 ± 0.5 and 2.9 ± 1.2, p <0.001). Increased serum creatinine levels at age 5 years were associated with later daytime and nighttime continence (mean ± SD 6.0 ± 3.2 and 5.5 ± 2.6 years, respectively, vs 4.1 ± 2.3 and 3.7 ± 1.4 years, respectively, in patients with normal serum creatinine, p ≤0.05). Prenatal or neonatal diagnosis of posterior urethral valves was associated with significantly delayed achievement of daytime continence compared to cases diagnosed later (mean ± SD 5.9 ± 3.6 vs 4.1 ± 1.8 years, p = 0.02). Patients with high nadir serum creatinine and vesicoureteral reflux initially also were at increased risk for urinary tract infections (p = 0.003 and p <0.001, respectively). Conclusions: Patients with posterior urethral valves achieve daytime and nighttime urinary continence significantly later than their healthy peers. Prenatal or neonatal diagnosis and high serum creatinine are associated with later attainment of continence. References 1 : Lower urinary tract symptoms in adults treated for posterior urethral valves in childhood: matched cohort study. J Urol2011; 186: 660. Link, Google Scholar 2 : Effects of posterior urethral valves on long-term bladder and sexual function. Nat Rev Urol2012; 9: 699. 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Volume 196Issue 1July 2016Page: 213-218 Advertisement Copyright & Permissions© 2016 by American Urological Association Education and Research, Inc.Keywordsurogenital abnormalitiesurinary incontinenceurethraMetricsAuthor Information Jenni Jalkanen Department of Pediatric Surgery, Kuopio University Hospital, Kuopio, Finland More articles by this author Jukka Heikkilä Department of Pediatric Surgery, Hyvinkää Hospital, Hospital District of Helsinki and Uusimaa, Hyvinkää, Finland More articles by this author Kristiina Kyrklund Department of Pediatric Surgery, Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland More articles by this author Seppo Taskinen Department of Pediatric Surgery, Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland More articles by this author Expand All Advertisement PDF downloadLoading ...