Are pressure pop-offs beneficial to the bladder in boys with posterior urethral valves?

D’Oro, Anthony; Meyer, Theresa; Gong, Edward M.; Rosoklija, Ilina; Liu, Dennis B.

doi:10.1016/j.jpurol.2020.05.154

Cited by 11 publications

(24 citation statements)

References 26 publications

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“…Classically, pop-off mechanisms have been considered to be protective factors of renal function in patients with PUV, but the data is contradictory and most studies do not include them as prognostic factors, study them separately, or do not define them correctly (6)(7)(8)(9)(10)(11)(15)(16)(17)(18) . Consequently, our study was specifically designed to try to clarify the real role that pop-off mechanisms play in the development of chronic or end-stage renal disease in patients with PUV.…”

Section: Discussionmentioning

confidence: 99%

“…Unilateral high-grade vesicoureteral reflux (VUR) with homolateral renal dysplasia, urinomas, urinary ascites, large bladder diverticula, and persistent urachus are considered pop-off mechanisms. Although these mechanisms have been historically defined as protective factors of renal function, most papers do not include these mechanisms as prognostic factors in patients with PUV, and study them separately or do not define them correctly (6)(7)(8)(9)(10)(11) . Therefore, the results of the studies published to date are contradictory in terms of the supposed renal protection of pop-off mechanisms in patients with PUV.…”

Section: Pop-off Mechanisms As Protective Factors Against Chronic Ren...mentioning

confidence: 99%

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Pop-off mechanisms as protective factors against chronic renal disease in children with posterior urethral valves

Massaguer¹,

Martín-Solé²,

Pérez-Bertólez³

et al. 2022

Cir Pediatr

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Objective. To identify whether pop-off mechanisms act as protective factors against chronic or end-stage renal disease in patients with posterior urethral valves. Materials and methods.A retrospective cohort study of patients with posterior urethral valves treated at a tertiary care children's hospital was carried out. Demographic, clinical, analytical, and radiological variables were collected. Considered as pop-off mechanisms were: unilateral high-grade vesicoureteral reflux with ipsilateral renal dysplasia and without involvement of the contralateral kidney, urinoma, prenatal urinary ascites, large bladder diverticulum, and persistent urachus. Multiple logistic regression and multivariate Cox regression were used for statistical analysis.Results. 70 patients undergoing posterior urethral valve surgery in our institution from 2010 to August 2020 were included. 14 (20%) had pop-off mechanisms and 56 (80%) did not. Pop-off mechanisms protected against developing chronic renal disease (0% vs. 27%; p = 0.03) and could protect against the need for renal replacement therapy (0% vs. 9%; p = 0.58). Nadir creatinine values (mg/dl) were predictors for the development of chronic renal disease (0.37 vs. 0.53; p < 0.0001) and the need for renal replacement therapy (0.38 vs. 1.21; p < 0.001).Conclusions. Pop-off mechanisms act as a protective factor against chronic renal disease in patients with posterior urethral valves. Nadir creatinine is a predictor of chronic renal disease and the need for renal replacement therapy. A larger sample size is needed to determine whether pop-off mechanisms protect against the need for renal replacement therapy.

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Section: Discussionmentioning

confidence: 99%

Section: Pop-off Mechanisms As Protective Factors Against Chronic Ren...mentioning

confidence: 99%

Pop-off mechanisms as protective factors against chronic renal disease in children with posterior urethral valves

Massaguer¹,

Martín-Solé²,

Pérez-Bertólez³

et al. 2022

Cir Pediatr

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“…Se consideran mecanismos pop-off el reflujo vesicoureteral (RVU) de alto grado unilateral con displasia renal homolateral, los urinomas, la ascitis urinaria, los divertículos vesicales grandes y el uraco persistente. A pesar de que históricamente estos fenómenos se han definido como protectores de la función renal, la mayoría de los trabajos no incluyen estos mecanismos como factores pronósticos de los pacientes con VUP, los estudian por separado o no los definen correctamente (6)(7)(8)(9)(10)(11) . Por ende, los resultados de los estudios publicados hasta la fecha son contradictorios en cuanto a la supuesta protección renal de los fenómenos pop-off en los pacientes con VUP.…”

Section: A R T í C U L O O R I G I N a Lunclassified

“…Edad tratamiento (años) Mediana (IQR) 0,18 (0,03 a 0,58) 0,07 (0,04 a 0,46) 0,22 (0,02 a 0,89) 0,43 Creatinina nadir (mg/dl) Mediana (IQR) 0,39 (0,35 a 0,47) 0,53 (0,46 a 0,71) 0,37 (0,34 a 0,4) Clásicamente, los mecanismos pop-off se han considerado como protectores de la función renal en los pacientes con VUP, pero los datos son contradictorios, la mayoría de estudios no los incluyen como factores pronósticos, los estudian por separado o no los definen correctamente (6)(7)(8)(9)(10)(11)(15)(16)(17)(18) . Consecuentemente, nues-tro estudio está específicamente diseñado para intentar esclarecer el papel real que juegan los fenómenos pop-off en el desarrollo de enfermedad renal crónica o terminal en los pacientes con VUP.…”

Section: Total (N = 70) Erc (N = 15) No Erc (N = 55) P-valorunclassified

“…En nuestro estudio, 14 pacientes (20%) presentaban fenómenos pop-off, hallazgos consistentes con la tasa reportada en algunas series (8,9,19) . Sin embargo, la prevalencia de fenómenos pop-off en otra serie fue del 65%, aunque no estaban correctamente definidos, incluyendo situaciones clínicas que no se consideran un verdadero fenómeno pop-off (11) . En cuanto al RVU, la tasa fue mayor en aquellos pacientes que presentaban fenómenos pop-off frente a aquellos que no (71 vs. 39%; p = 0,039).…”

Section: Total (N = 70) Erc (N = 15) No Erc (N = 55) P-valorunclassified

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Los fenómenos pop-off como factores de enfermedad renal crónica en niños con válvulas de uretra posterior

Massaguer¹,

Solé²,

Pérez-Bertólez³

et al. 2022

Cir Pediatr

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C. Massaguer y cols.CIRUGÍA PEDIÁTRICA ResumenObjetivos. Identificar si los fenómenos pop-off actúan como factores protectores de enfermedad renal crónica o terminal en pacientes con válvulas de uretra posterior.Material y métodos. Estudio de cohortes retrospectivo de los pacientes con válvulas de uretra posterior tratados en un hospital infantil de tercer nivel. Se recogieron variables demográficas, clínicas, analíticas y radiológicas. Se consideraron fenómenos pop-off: reflujo vesicoureteral de alto grado unilateral con displasia renal ipsilateral y sin afectación del riñón contralateral, urinoma, ascitis urinaria prenatal, divertículo vesical grande y uraco persistente. Para el análisis estadístico se han utilizado regresiones logísticas múltiples y regresión de Cox multivariante.Resultados. Se incluyeron 70 pacientes intervenidos de válvulas de uretra posterior y visitados en nuestro centro desde 2010 hasta agosto de 2020. Catorce (20%) presentaban fenómenos pop-off y 56 (80%) no. Los fenómenos pop-off fueron protectores para el desarrollo de enfermedad renal crónica (0 vs. 27%; p = 0,03) y podrían proteger de la necesidad de terapia renal sustitutiva (0 vs. 9%; p = 0,58). Los valores de creatinina nadir (mg/dl) fueron predictores de desarrollo de enfermedad renal crónica (0,37 vs. 0,53; p < 0,0001) y de necesidad de terapia renal sustitutiva (0,38 vs. 1,21; p < 0,001).Conclusiones. Los fenómenos pop-off actúan como factor protector de enfermedad renal crónica en los pacientes con válvulas de uretra posterior. La creatinina nadir es un factor predictor de enfermedad renal crónica y de necesidad de terapia renal sustitutiva. Se necesita un tamaño de muestra mayor para determinar si los fenómenos pop-off protegen de la necesidad de terapia renal sustitutiva.Palabras Clave: CAKUT; Válvulas de uretra posterior; Fenómenos pop-off; Insuficiencia renal crónica. Pop-off mechanisms as protective factors against chronic renal disease in children with posterior urethral valves AbstractObjective. To identify whether pop-off mechanisms act as protective factors against chronic or end-stage renal disease in patients with posterior urethral valves. Materials and methods.A retrospective cohort study of patients with posterior urethral valves treated at a tertiary care children's hospital was carried out. Demographic, clinical, analytical, and radiological variables were collected. Considered as pop-off mechanisms were: unilateral highgrade vesicoureteral reflux with ipsilateral renal dysplasia and without involvement of the contralateral kidney, urinoma, prenatal urinary ascites, large bladder diverticulum, and persistent urachus. Multiple logistic regression and multivariate Cox regression were used for statistical analysis.Results. 70 patients undergoing posterior urethral valve surgery in our institution from 2010 to August 2020 were included. 14 (20%) had pop-off mechanisms and 56 (80%) did not. Pop-off mechanisms protected against developing chronic renal disease (0% vs. 27%; p = 0.03) and could protect against the need...

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Posterior Urethral Valves

et al. 2023

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Are pressure pop-offs beneficial to the bladder in boys with posterior urethral valves?

Cited by 11 publications

References 26 publications

Pop-off mechanisms as protective factors against chronic renal disease in children with posterior urethral valves

Pop-off mechanisms as protective factors against chronic renal disease in children with posterior urethral valves

Los fenómenos pop-off como factores de enfermedad renal crónica en niños con válvulas de uretra posterior

Posterior Urethral Valves

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