Serial voiding urosonography in posterior urethral valve diagnosis and management in pediatric patients

Report our experience with the use of contrast-enhanced serial voiding urosonography (SVU) for posterior urethral valve (PUV) patient diagnosis and management. Descriptive retrospective study in 0- to 14-year-old patients with suspected PUV at SVU performed as a first contrast-enhanced urinary tract...

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Published inCirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica Vol. 33; no. 1; p. 36
Main Authors Rojas-Ticona, J, Fernández Córdoba, M S, Cabezalí Barbancho, D, Marijuán Sahuquillo, V, Argumosa Salazar, Y M, Ramírez Piqueras, M, Moratalla Jareño, T, Hernández Anselmi, E J, Vidal Company, A, Parrondo Muiños, C
Format Journal Article
LanguageEnglish
Published Spain 20.01.2020
Subjects
Adolescent
Child
Child, Preschool
Contrast Media
Creatinine - blood
Cystoscopy
Humans
Infant
Infant, Newborn
Male
Recurrence
Reoperation
Retrospective Studies
Ultrasonography - methods
Urethra - abnormalities
Urethra - diagnostic imaging
Urethra - surgery
Urethral Diseases - diagnostic imaging
Urethral Diseases - surgery
Urination
Posterior urethral valves
Voiding urosonography
Ultrasound cystography
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Summary:Report our experience with the use of contrast-enhanced serial voiding urosonography (SVU) for posterior urethral valve (PUV) patient diagnosis and management. Descriptive retrospective study in 0- to 14-year-old patients with suspected PUV at SVU performed as a first contrast-enhanced urinary tract test with subsequent cystoscopic study. Variables were analyzed using SPSSv22. 18 patients were studied (median age: 6 months). Most patients (15) presented posterior urethral dilatation (mean diameter: 9.56 mm) and a >2 mm gap between proximal and distal urethra. 13 cases had bladder thickening and 9 had VUR. 15 PUV cases, 1 case of distal urethral mucocele, and 1 case of bladder diverticulum obstructing the urethra were diagnosed. Complete PUV resection was performed in 10 patients (66.6%) at the first cystoscopy. The control SVU detected one case of recurrence due to persistence of posterior urethral dilatation. The recurrence case and the 5 incomplete resection cases were treated with a second cystoscopy and resection. The youngest patients required a third resection and cutting balloon dilatation due to residual stenosis. Mean creatinine levels at diagnosis were 0.28 mg/dl. Serial voiding urosonography (SVU) is a useful complementary test in pediatric patients with posterior urethral valve. Its dynamic nature and its advantages - absence of irradiation, safety, and high sensitivity - make it an ideal imaging test for PUV diagnosis and follow-up.
ISSN:2445-2807