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Lower Urinary Tract Symptoms in Adults Treated for Posterior Urethral Valves in Childhood
ESPU Programme 2010 CONCLUSIONS CA 19-9 in fetal urine and amitotic fluid is a clinically applicable marker in congenital
S47 obstructive nephropathy (PUV). Our findings may propose that the proper decline in urinary Ca19-9 levels in fetus is a predictive
of excellent surgical and renal function outcomes.
S05-2 (PP) LOWER URINARY TRACT SYMPTOMS IN ADULTS TREATED FOR POSTERIOR URETHRAL VALVES IN CHILDHOOD ¨2, Risto RINTALA1, Teuvo TAMMELA3 and Kari O. TIKKINEN4 Seppo TASKINEN1, Jukka HEIKKILA 1 3
Helsinki University Central Hospital, Pediatric Surgery, Helsinki, FINLAND, 2Hyvinka¨a¨ Hospital, Pediatric Surgery, Hyvinka¨a¨, FINLAND, Tampere University Hospital, Surgery, Tampere, FINLAND, 4Helsinki University Central Hospital, Urology, Helsinki, FINLAND
PURPOSE Lower urinary tract symptoms (LUTS) are common in children with posterior urethral valves (PUV). In the present study we compared the prevalence of LUTS between adult patients treated for PUV in childhood and age-matched population-based cohort.
MATERIAL AND METHODS Information on LUTS was assessed using the Danish Prostatic Symptom Score (DAN-PSS) questionnaire. Out of 108 PUV patients, 69 (64%) returned the questionnaire. Agematched-cohort of 1,242 men (randomly
identified from the population register) was used as a control.
RESULTS The median age of the 69 patients and controls was 38 years (age range: 17-57 for patients and 18 -57 for controls). Both any urgency and any stress incontinence were more common in the patients than in the controls (14.5% and 11.6% vs. 6.3% and 3.6%, p¼0.02 and p¼<0.01). The following symptoms were more common in the patients than in the controls: any nocturia (43.5% vs. 26.3%, p<0.01), at least moderate straining (14.5% vs. 4.5% (p<0.01) and at
least moderate incomplete emptying (8.7% vs. 3.5%, p¼0.04). Fifteen of the 69 patients (22%) had originally had a temporary bilateral ringtype ureterocutaneostomy because of severe disease and seven patients (10%) had later undergone kidney transplantation. The incidence of LUTS did not differ between these groups and those without primary stoma and kidney transplantation.
CONCLUSIONS In adulthood PUV patients have more LUTS than normal population.
DP02: POSTERIOR URETHRAL VALVES - DISCUSSED POSTER 2
# DP02-1 (DP) RENAL EFFICACY OF MITROFANOFF DRAINANGE IN BOYS WITH PUV Liam MCCARTHY, Harriet CORBETT, Harish CHANDRAN and Karan PARASHAR Birmingham Children’s Hospital, Paediatric Urology, Birmingham, UNITED KINGDOM
PURPOSE
MATERIAL AND METHODS
RESULTS
Boys with posterior urethral valves (PUV) progress to end stage renal failure (ESRF) in 1/4 cases. It has been hypothesized that Mitrofanoff formation and intermittent catheterization with overnight drainage protects renal function. This benefit has not been quantified. Mitrofanoff formation has been performed at our centre for many years. Boys with PUV who had Mitrofanoff formation were identified and renal status pre and post-op compared, as was age at onset of ESRF in the Mitrofanoff group compared to historical controls.
A retrospective analysis of boys with PUV and Mitrofanoff formation was performed, and a database of (ESRF) patients searched. Firstly, comparison of pre and post Mitrofanoff renal function and hydronephrosis was made. Secondly the age (years) at which PUV boys progressed to ESRF with and without Mitrofanoff drainage was compared. Results given as meanSEM. Statistical analysis was by paired or 2sample students t-test as appropriate, p<0.05 taken as significant.
Mitrofanoff formation was performed in 25 PUV boys. Data for 19 patients pre-op and post-op creatinine (11818 mmol/l vs. 12522 mmol/l), was not significantly different, p¼0.13. Hydronephrosis was significantly reduced in 26 renal units, pre-op 1.90.1 cm vs. post-op 1.10.1 cm, p<0.001. Long-term 5 boys with Mitrofanoffs progressed to ESRF at 13.81.1 yrs whereas ESRF occurred in 28 historical controls at 8.00.9yrs, p<0.01.
S47 obstructive nephropathy (PUV). Our findings may propose that the proper decline in urinary Ca19-9 levels in fetus is a predictive
of excellent surgical and renal function outcomes.
S05-2 (PP) LOWER URINARY TRACT SYMPTOMS IN ADULTS TREATED FOR POSTERIOR URETHRAL VALVES IN CHILDHOOD ¨2, Risto RINTALA1, Teuvo TAMMELA3 and Kari O. TIKKINEN4 Seppo TASKINEN1, Jukka HEIKKILA 1 3
Helsinki University Central Hospital, Pediatric Surgery, Helsinki, FINLAND, 2Hyvinka¨a¨ Hospital, Pediatric Surgery, Hyvinka¨a¨, FINLAND, Tampere University Hospital, Surgery, Tampere, FINLAND, 4Helsinki University Central Hospital, Urology, Helsinki, FINLAND
PURPOSE Lower urinary tract symptoms (LUTS) are common in children with posterior urethral valves (PUV). In the present study we compared the prevalence of LUTS between adult patients treated for PUV in childhood and age-matched population-based cohort.
MATERIAL AND METHODS Information on LUTS was assessed using the Danish Prostatic Symptom Score (DAN-PSS) questionnaire. Out of 108 PUV patients, 69 (64%) returned the questionnaire. Agematched-cohort of 1,242 men (randomly
identified from the population register) was used as a control.
RESULTS The median age of the 69 patients and controls was 38 years (age range: 17-57 for patients and 18 -57 for controls). Both any urgency and any stress incontinence were more common in the patients than in the controls (14.5% and 11.6% vs. 6.3% and 3.6%, p¼0.02 and p¼<0.01). The following symptoms were more common in the patients than in the controls: any nocturia (43.5% vs. 26.3%, p<0.01), at least moderate straining (14.5% vs. 4.5% (p<0.01) and at
least moderate incomplete emptying (8.7% vs. 3.5%, p¼0.04). Fifteen of the 69 patients (22%) had originally had a temporary bilateral ringtype ureterocutaneostomy because of severe disease and seven patients (10%) had later undergone kidney transplantation. The incidence of LUTS did not differ between these groups and those without primary stoma and kidney transplantation.
CONCLUSIONS In adulthood PUV patients have more LUTS than normal population.
DP02: POSTERIOR URETHRAL VALVES - DISCUSSED POSTER 2
# DP02-1 (DP) RENAL EFFICACY OF MITROFANOFF DRAINANGE IN BOYS WITH PUV Liam MCCARTHY, Harriet CORBETT, Harish CHANDRAN and Karan PARASHAR Birmingham Children’s Hospital, Paediatric Urology, Birmingham, UNITED KINGDOM
PURPOSE
MATERIAL AND METHODS
RESULTS
Boys with posterior urethral valves (PUV) progress to end stage renal failure (ESRF) in 1/4 cases. It has been hypothesized that Mitrofanoff formation and intermittent catheterization with overnight drainage protects renal function. This benefit has not been quantified. Mitrofanoff formation has been performed at our centre for many years. Boys with PUV who had Mitrofanoff formation were identified and renal status pre and post-op compared, as was age at onset of ESRF in the Mitrofanoff group compared to historical controls.
A retrospective analysis of boys with PUV and Mitrofanoff formation was performed, and a database of (ESRF) patients searched. Firstly, comparison of pre and post Mitrofanoff renal function and hydronephrosis was made. Secondly the age (years) at which PUV boys progressed to ESRF with and without Mitrofanoff drainage was compared. Results given as meanSEM. Statistical analysis was by paired or 2sample students t-test as appropriate, p<0.05 taken as significant.
Mitrofanoff formation was performed in 25 PUV boys. Data for 19 patients pre-op and post-op creatinine (11818 mmol/l vs. 12522 mmol/l), was not significantly different, p¼0.13. Hydronephrosis was significantly reduced in 26 renal units, pre-op 1.90.1 cm vs. post-op 1.10.1 cm, p<0.001. Long-term 5 boys with Mitrofanoffs progressed to ESRF at 13.81.1 yrs whereas ESRF occurred in 28 historical controls at 8.00.9yrs, p<0.01.