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  • Title: Does neonatal pyeloureterostomy worsen bladder function in children with posterior urethral valves?
    Author: Jaureguizar E, Lopez Pereira P, Martinez Urrutia MJ, Espinosa L, Lobato R.
    Journal: J Urol; 2000 Sep; 164(3 Pt 2):1031-3; discussion 1033-4. PubMed ID: 10958734.
    Abstract:
    PURPOSE: We determine whether long-term bladder dysfunction is more frequent in children with posterior urethral valves who undergo early supravesical urinary diversion (pyeloureterostomy) than in those who undergo valve ablation. MATERIALS AND METHODS: Urodynamic studies were performed in 59 boys with severe posterior urethral valves who were divided into 2 groups based on initial treatment of valve ablation (30) and bilateral pyeloureterostomy (29). RESULTS: Of the 59 boys 25 (42%) had a normal bladder, including 11 with an over distended bladder and 34 (58%) had bladder dysfunction, including instability in 22, poor compliance in 9 and myogenic failure in 3. Of the 30 boys initially treated with valve ablation 14 (46.6%) had a normal bladder, including 7 with an over distended bladder and 16 (53.4%) had bladder dysfunction, including instability in 10, poor compliance in 4 and myogenic failure in 2. Of the 29 boys initially treated with temporary bilateral pyeloureterostomy 11 (38%) had normal bladders, 4 with an over distended bladder and 18 (62%) had bladder dysfunction, including instability in 12, poor compliance in 5 and myogenic failure in 1. There were no statistically significant differences in the number or type of bladder dysfunction between the diversion and valve ablation groups. CONCLUSIONS: Therefore, temporary pyeloureterostomy did not affect bladder function adversely in the long term.
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