Posterior Urethral Valves, Pressure Pop-offs and Bladder Function

No AccessJournal of UrologyHydronephrosis: Clinical1 Aug 1995Posterior Urethral Valves, Pressure Pop-offs and Bladder Function Martin Kaefer, Michael A.* Keating, Mark C. Adams, and Richard C. Rink Martin KaeferMartin Kaefer More articles by this author , Michael A.* KeatingMichael A.* Keating More articles by this author , Mark C. AdamsMark C. Adams More articles by this author , and Richard C. RinkRichard C. Rink More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)67138-6AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail The pop-off mechanisms that sometimes occur with posterior urethral valves have well recognized implications for renal function, such that 1 or both kidneys can be protected from the deleterious effects of elevated bladder pressures. What has not been defined is the significance, if any, of pressure pop-offs to the developing bladder and ultimate bladder function. To answer this question we reviewed the records of 63 boys with posterior urethral valves. Eight boys who were not yet toilet trained had unevaluable bladder outcomes. Of the 55 remaining boys there was 1 or more pressure pop-off in 39 (71 percent), including massive (grade 5) reflux, massive reflux associated with ipsilateral renal dysplasia, a patent urachus, large diverticula and urinomas. Bladder outcomes were judged as favorable or unfavorable on the basis of urodynamic parameters and/or patient clinical status. A statistically significant positive correlation was found between the presence of a pop-off and a favorable outcome. Favorable characteristics were found in 34 of 39 bladders (87 percent) with pressure pop-offs. In contrast, only 9 of 16 bladders (55 percent) without pressure vents had favorable outcomes. In addition, 5 of the remaining 7 boys without pressure vents have required augmentation cystoplasty. A direct correlation between absolute number of pop-offs and favorable bladder outcome was also noted, further emphasizing this relationship. The presence of a pressure pop-off is a favorable prognostic sign for ultimate bladder function in boys with posterior urethral valves. References 1 : Posterior urethral valves, unilateral reflux and renal dysplasia: a syndrome. J. Urol.1982; 128: 994. Link, Google Scholar 2 : Vesicoureteral reflux in children: a computerized review. J. Urol.1973; 109: 888. Link, Google Scholar 3 : Estimating bladder capacity in children. Urology1983; 21: 248. Crossref, Medline, Google Scholar 4 : Prognosis of posterior urethral valves presenting at birth. J. Ped. Surg.1986; 21: 43. Google Scholar 5 : The predictive value of ultrasonography in evaluation of infants with posterior urethral valves. J. Urol.1992; 148: 122. 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Link, Google Scholar Division of Pediatric Urology, James Whitcomb Riley Hospital for Children and Department of Urology, Indiana University School of Medicine, Indianapolis, Indiana.© 1995 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byHoag N, MacNeily A, Abdi H, Figueroa V and Afshar K (2014) VURD Syndrome—Does it Really Preserve Long-Term Renal Function?Journal of Urology, VOL. 191, NO. 5S, (1523-1526), Online publication date: 1-May-2014.GHANEM M, WOLFFENBUTTEL K, DE VYLDER A and NIJMAN R (2018) LONG-TERM BLADDER DYSFUNCTION AND RENAL FUNCTION IN BOYS WITH POSTERIOR URETHRAL VALVES BASED ON URODYNAMIC FINDINGSJournal of Urology, VOL. 171, NO. 6 Part 1, (2409-2412), Online publication date: 1-Jun-2004.BACKHAUS B, KAEFER M, HABERSTROH K, HILE K, NAGATOMI J, RINK R, CAIN M, CASALE A and BIZIOS R (2018) Alterations in the Molecular Determinants of Bladder Compliance at Hydrostatic Pressures less than 40 cm. 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Volume 154Issue 2August 1995Page: 708-711 Advertisement Copyright & Permissions© 1995 by American Urological Association, Inc.Metrics Author Information Martin Kaefer More articles by this author Michael A.* Keating More articles by this author Mark C. Adams More articles by this author Richard C. Rink More articles by this author Expand All Advertisement PDF downloadLoading ...