Introduction & Objective : Objectives:This study was designed to assess the importance of routine (second look) cystoscopy after primary ablation of posterior urethral valve.
Methods : Patients and methods: Prospective study was conducted at Kasr Alainy pediatric hospital (aboulreesh) , Urology department, Cairo University on 50 male children, aged less than 5 years old diagnosed to have PUV between September 2016 and June 2017. Diagnosis of posterior urethral valve was made by voiding symptoms, ultrasonography and confirmed by voiding cysto-urethrogram (VCUG). All children were treated by endoscopic ablation of posterior urethral valves (PUV) using cold knife and were followed clinically for voiding symptoms and with ultrasonography and laboratory tests. All patients underwent 2nd look cystoscopy one month after 1ry valve ablation to see residual valves irrespective of their clinical improvement.
Results: Mean age at presentation was 8.3 ± 12.6 months. The most common presenting symptoms were acute urine retention in (44%),obstructive symptoms in (42%),antenatal diagnosis in (13%)and recurrent febrile UTI in (10%) . 92% showed Hydronephrosis at presentation . Serum creatinine was elevated in 72% at presentation. Residual valves on 2nd look cystoscopy were found in 60%.No evidence of significant statistical relationship between symptoms and investigation results pre and post valve ablation and the presence of residual valve during 2nd look cystoscopy after 1ry valve ablation except the presence of post voiding residual urine in post ablation ultrasound (p=0.035). There is evidence of statistical relationship between the age of patient at presentation and presence of residual valve (p=0.021 ).
Conclusion: Significant number of patients had residual valve on second look cystoscopy. We recommend second look cystoscopy one month after 1ry valve ablation for early detection of any residual obstructive valve even with the improvement of other parameters of follow up in these patients.
Waseem Aboul ela– Lecturer , Aboul Reech hospital Cairo university , Cairo, Al Qahirah, Egypt
Mohamed Abdel Ghany– Cairo, Al Qahirah, Egypt
Ahmed Abou zamel– Cairo, Al Qahirah, Egypt
Mohamed Abdel Wahab– Cairo, Al Qahirah, Egypt
Waleed Ghoniema– Cairo, Al Qahirah, Egypt
Ahmed Shouman– Cairo, Al Qahirah, Egypt
Ahmed Shokry– Cairo, Al Qahirah, Egypt
Mohamed El sheemy– Cairo, Al Qahirah, Egypt
Ashraf Emran– Cairo, Al Qahirah, Egypt
Mohamed El Ghoniemy– Cairo, Al Qahirah, Egypt
Hani Morsi– Cairo, Egypt
Sameeh Zamel– Cairo, Al Qahirah, Egypt
Hesham Badawy– Cairo, Al Qahirah, Egypt
Aboul Reech hospital Cairo university
Cairo, Al Qahirah, Egypt
waseem nabil aboul ela lecturer of urology in aboul reech pediatric hospital cairo university