Category: Endoscopic

MP21-1 - Is it important to do second look cystoscopy after posterior urethral valve ablation in children?

Sat, Sep 22
2:00 PM - 4:00 PM

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 :  
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 ). 


Conclusions :
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

waseem nabil aboul ela lecturer of urology in aboul reech pediatric hospital cairo university

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