Correlation Between Posterior/Anterior Urethral Ratio from Voidingcystourethrography and Prognosis of Posterior Urethral Vales
Keywords:
Posterior urethral valvas, Posterior/anterior urethral caliber ratio, Voiding cystourethrography, PrognosisAbstract
Purpose: To determine the correlation between the posterior/anterior urethral caliber ratio and the renal and bladder function after definite rreatment for posterior urethral valves (PUV). and to evaluate the prognostic variables affecting the renal function in the patients with PUV.
Material and Method: We retrospectively reviewed the medical records and voiding cystourethrography (VCUG) of the patients who were diagnosed as having PUV from January 2004 to June 2013. The Posterior/anterior urethral caliber ratio was measured from VCUG at diagnosis and the data including age at diagnosis, clinical presentation of the disease, degree of vesicoureteral reflux (VUR), temporary urinary diversion type, renal function at diagnosis, the best renal function after temporary urinary diversion and at the latest visit were collected.
Results: Of 20 patients, mean±SD of age at dianosis was 22.6±28.4 months (range 0.03-84 monts). Mean±SD of posterior/anterior urethral caliber ratio at the time of diagnosis was 3.4±1.64 (range 1.3-6.4). Mean±SD of glomerrular filtration rate (GFR) at diagnosis and at the latest visit were 39.5±39.7 ml/min/1.73m2 and 87.7±50.3 ml/min/1.73 m2 , respectively. VUR was found in 27 renal units. Valve bladder syndrome (VBS) was diagnosed in 13 patients (68%). No correlation was found between the posterior/anterior urethral caliber ratio and renal function at various time, and also between the uretharll ratio and VBS. Only GFR nadir after diversion was related to the outcome of renal function.
Conclusion: Although the posterior/anterior urethral caliber ratio was not correlated with the renal function and bladder fuction after treatment of PUV, the significant factors that could predict the renal function after treatment was serum GFR after temporary urinary diversion.
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Copyright (c) 2016 By the authors. Licensee RMJ, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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