Long-term renal outcome in infants with congenital lower urinary tract obstruction
| Autor: | O. Larmure, V. Gomola, J.L. Lemelle, C. Mazeaud, I. Vrillon, C. Ayav, N. Berte |
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| Přispěvatelé: | Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Service de Chirurgie Viscérale Pédiatrique [CHRU Nancy], Service d'Epidémiologie et Evaluations Cliniques [CHRU Nancy] (Pôle S2R), Consultation méthodo et stat CIC-EC |
| Rok vydání: | 2017 |
| Předmět: |
Posterior urethral valve
Paediatric urology Male Time Factors medicine.medical_treatment 030232 urology & nephrology urologic and male genital diseases Kidney 0302 clinical medicine Urethral Diseases Trigone of urinary bladder Child ComputingMilieux_MISCELLANEOUS 030219 obstetrics & reproductive medicine medicine.diagnostic_test Cystoscopy Paediatric nephrology 3. Good health Urinary Bladder Neck Obstruction medicine.anatomical_structure Treatment Outcome Child Preschool Female Urinary tract obstruction medicine.medical_specialty Urethral Obstruction Adolescent Urology Urinary system Posterior urethral valves 03 medical and health sciences Young Adult medicine Humans Retrospective Studies business.industry Urinary diversion Infant Newborn Infant Recovery of Function medicine.disease Neck of urinary bladder Urethra Urogenital Abnormalities Lower urinary tract obstruction (LUTO) [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie business Congenital anomalies of the kidney and the urinary tract (CAKUT) Follow-Up Studies |
| Zdroj: | Progrès en Urologie Progrès en Urologie, Elsevier Masson, 2018, 28 (12), pp.596-602. ⟨10.1016/j.purol.2018.06.005⟩ |
| ISSN: | 1166-7087 |
| DOI: | 10.1016/j.purol.2018.06.005⟩ |
| Popis: | Summary Introduction Congenital Lower Urinary Tract Obstructions (LUTO) is a heterogeneous group of diseases in which urine elimination is obstructed at the level of bladder neck or urethra. The aim of the study is to evaluate the long-term renal outcome of patients suffering of congenital LUTO. Patients and method We retrospectively reviewed patients with congenital LUTO. All patients had at least 1 year follow-up. Data on surgery, renal imaging and Schwartz estimate creatinine clearance were collected. Incidence of Chronic Renal Disease (CRD) is presented with Kaplan-Meier method. Results 40 patients were included, 23 patients with Posterior Urethral Valve (PUVs) and 17 patients with other aetiologies: anterior urethral valve (2), urethral atresia (2), urethral stenosis (2), cloacal malformations (2), obstructive ureterocele (1), bladder trigone malformation (1) and neonatal bladder-sphincter dysfunction without neurological abnormalities (7). Incidence of CRD at age 10 years was 37% in congenital LUTO, 42% in PUVs and 30% in other aetiologies, and was significantly higher in PUVs ( P = 0.032). Renal prognosis was significantly worsened by discover of retentional bladder wall changes in initial cystoscopy, and by loss of parenchymal differentiation or cortical microcysts in first ultrasonography. The use of urinary diversion was significantly higher in LUTO of other aetiologies. Conclusion A high incidence of CRD is observed in patients with congenital LUTO, significantly higher in patients with PUV. LUTO of other aetiologies require step by step surgical management and higher use of urinary diversion. Precise initial evaluation in cystoscopy and ultrasonography is required and participate to evaluate future renal outcome. Level of incidence 4. |
| Databáze: | OpenAIRE |
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