Can transient resting of the bladder with vesicostomy reduce the need for a major surgery in some patients?

Sharifiaghdas, Farzaneh; Mirzaei, Mahboubeh; Nikravesh, Nadia

doi:10.1016/j.jpurol.2019.03.026

Cited by 11 publications

(3 citation statements)

References 19 publications

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“…Such practice of diversion procedure has been reported by others. 18,19 Endoscopic valve fulguration was done in 27 (93%) of cases. Other studies have reported a similar pattern of endoscopic valve fulguration.…”

Section: Discussionmentioning

confidence: 99%

Clinical profile of children with posterior urethral valve at Tertiary Care Center

et al. 2022

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Background & Objective: Posterior Urethral Valves (PUV) are common cause of congenital obstructive uropathy in boys and may be associated with urinary tract infection(UTI) and chronic kidney disease(CKD) if not managed timely. The objective of our study was to determine the clinical profile of children with PUV. Methods: This is a descriptive case series comprising of 30 children aged 1-5 years, diagnosed and managed as PUV over six months, conducted at the Department of Pediatric Nephrology, National Institute of Child Health, Karachi. Patients were followed for 12 weeks and the outcome was assessed in terms of recovery, UTI, urinary incontinence and CKD. Descriptive statics were used for data analysis. Results: Thirty cases of PUV were managed during study period. Clinical presentations were poor urinary stream (83%), fever (73%), signs and symptom suggesting UTI (96.6%), pallor (73.3%), acute kidney injury (37%)and urinary retention (13%). UTI was confirmed in 73.3 % and E.Coli was the most common pathogen. Ultrasonography showed bilateral hydronephrosis/hydroureter in 80% and micturating cystourethrogram demonstrated vesicoureteral reflux in 86.66% cases. All patients received intravenous hydration (97%), urinary decompression, and antibiotics. Meropenem was the most commonly used. Packed cell transfusion and peritoneal dialysis was done in 73.33% and 13.3% respectively. Cystoscopic valve fulguration was done in 86.66% and vesicostomy in 13.3%. On short-term follow-up, 60% recovered,16.66% experienced UTI and remained incontinent whereas 23.33% had CKD. Conclusion: Our study showed a high frequency of UTI and AKI. E. coli was most common pathogen. Despite valve fulgration, significant patients had CKD. doi: https://doi.org/10.12669/pjms.38.7.5823 How to cite this:Yamin R, Moorani K, Shaikh M, Yamin S. Clinical profile of children with posterior urethral valve at Tertiary Care Center. Pak J Med Sci. 2022;38(7):1821-1826. doi: https://doi.org/10.12669/pjms.38.7.5823 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Section: Discussionmentioning

confidence: 99%

Clinical profile of children with posterior urethral valve at Tertiary Care Center

et al. 2022

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“…Podesta et al showed that it is an effective method for infants with high-grade VUR and urosepsis [21]. Also, in the study of Shari aghdas et al, 15 infants younger than 6 months bene ted from this treatment method [22]. However, temporary vesicostomy is a more invasive method than endoscopic injection therapy, and at least one additional anesthesia session is needed for vesicostomy closing and treating possible ongoing re ux.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Management of Complicated High-Grade Vesicoureteral Reflux in the First Year of Life

Tekın

Tiryaki

Yağmur

et al. 2021

Preprint

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Purpose:The treatment of high-grade vesicoureteral reflux in infants is controversial. Subureteric injection has been tried recently with its advantage of easy application and less invasiveness. In this study, we aimed to assess the efficacy of endoscopic sub-ureteric injection to correct high-grade reflux in infants with documented indications for anti-reflux surgery.Materials and Methods:Hospital records of high-grade (grade 4-5) VUR patients who had undergone endoscopic sub-ureteric injection in the first year of life with documented breakthrough infections, between 2009-2016 were reviewed. Radiologic success was defined as complete resolution of reflux in VCUG obtained at least three months after the injection and clinical success was defined as the downgrading of reflux degree below three and absence of urinary infection.Results:A total of 23 patients with 34 high-grade refluxing units were included in the study. The mean age at first injection was 6.3±1.8 months (1-11 months). Radiologic success rate with initial injection was 61.7% and increased to 85.2% after repeated injections. The overall clinical success rate at first injection was 70.6% and 97.1% after repeated injections. Mean injected material volume was 0.34±0.27 (0.1-1) ml per ureter. Conclusion:Endoscopic treatment is a successful alternative in infants with high-grade vesicoureteral reflux suffering breakthrough infections.

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“…[2]. Главные недостатки везикостомии -отсутствие континенции и высокая частота осложнений, именно поэтому данный метод в подавляющем большинстве случаев является временным [14]. К основным осложнениям относят стенозирование стомы, эвагинацию мочевого пузыря через стому, прогрессирующую инфекцию мочевыводящих путей.…”

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Modern view on the problem of urine diversion in children with severe urinary disorders

Ignatyev

Гусева

Борисовна³

et al. 2021

Russian Journal of Pediatric Surgery, Anesthesia and Intensive

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Urination is a complex multicomponent process. Urinary disorders often lead to serious consequences on the urinary system, social maladaptation, and impairment of the quality of children's lives. Due to the large number of pathologies leading to these disorders and the involvement of several systems (for example, the nervous system in myelodysplasia), the doctor must be extensively knowledgeable and experienced in related fields. Surgical methods of urinary diversion have a long history. Surgeons worldwide have been trying to solve this problem for many decades, but it remains relevant and unsolved. The wide variety of urinary disorders has a correspondingly impressive number of types and options of surgical interventions. The goals of these surgical techniques are to correct the anatomical and clinical aspects of the disorders and assure the childs socio-psychological adaptation. Surgeons must consider many factors such as all the pathogenetic nuances of an underlying disease, comorbidities, the childs constitutional features, prospects for his or her social adaptation, the family home environment, parents willingness to and focus on long and challenging treatment. Based on these details, it is evident that urinary diversion in children is a multifaceted problem. It requires a very careful and individualized approach to each patient to ensure choosing the optimal treatment method in each case. This choice will affect many aspects of the childs life, including his or her social adaptation, the ability to obtain an education and lead an almost normal lifestyle. The aim of this study is to review and systematize the accumulated knowledge on this subject.

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Can transient resting of the bladder with vesicostomy reduce the need for a major surgery in some patients?

Cited by 11 publications

References 19 publications

Clinical profile of children with posterior urethral valve at Tertiary Care Center

Clinical profile of children with posterior urethral valve at Tertiary Care Center

Endoscopic Management of Complicated High-Grade Vesicoureteral Reflux in the First Year of Life

Modern view on the problem of urine diversion in children with severe urinary disorders

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