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posterior urethral valves

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https://www.readbyqxmd.com/read/29229166/holding-water-congenital-anomalies-of-the-kidney-and-urinary-tract-ckd-and-the-ongoing-role-of-excellence-in-plumbing
#1
REVIEW
Lars J Cisek
Congenital anomalies of the kidneys and urinary tracts can result in diminished natal kidney function, possibly through common embryologic pathway disruption or as a result of development taking place in the face of disordered 'post-renal' drainage. Impaired conduit and reservoir function present potential for an ongoing assault leading to further deterioration and progression of chronic kidney disease, a risk that extends to adults with these conditions, even after "correction". The drainage and storage aspects of the urinary system that can impact kidney function are reviewed with attention to correctable or manageable problems including: Bladder dysfunction wherein the low pressure storage of urine is compromised requiring the kidney to work against a pressure gradient, the classic post renal failure problem...
November 2017: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/29225122/dual-pathology-causing-congenital-bladder-outlet-obstruction
#2
Ruth Kwong, Navroop S Johal, Anand Upasani, Anu Paul, Peter Cuckow
Anterior urethral syringocele is an uncommon congenital deformity characterised by cystic dilatation of bulbo-urethral gland ducts and is usually asymptomatic. We present a case on 4-day-old male neonate who presented with bilateral antenatal hydroureteronephrosis and renal impairment and found to have urethral syringocele and posterior urethral valves (PUV).
December 7, 2017: Urology
https://www.readbyqxmd.com/read/29223674/prediction-of-need-for-intervention-in-posterior-urethral-valves-use-of-urine-osmolality
#3
Anna E Wright, Ruth Wragg, Joana Lopes, Andrew Robb, Liam McCarthy
AIM: Renal tubular dysfunction (RTD) causing obligate production of hypoosmolar urine in boys with posterior urethral valves (PUVs) has been described. It is not known how clinically significant this is. We hypothesize that a feedback loop is present in many PUV boys who suffer deterioration of their lower urinary tract (LUT). RTD results in hypoosmolar urine, obligate polyuria, and bladder stretch-injury. The increasing back-pressure worsens RTD, thus exacerbating the injury. Coexisting renal dysplasia and acquired renal scarring exacerbate this...
November 14, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29198536/infants-with-atypical-presentations-of-alveolar-capillary-dysplasia-with-misalignment-of-the-pulmonary-veins-who-underwent-bilateral-lung-transplantation
#4
Christopher T Towe, Frances V White, R Mark Grady, Stuart C Sweet, Pirooz Eghtesady, Daniel J Wegner, Partha Sen, Przemyslaw Szafranski, Pawel Stankiewicz, Aaron Hamvas, F Sessions Cole, Jennifer A Wambach
OBJECTIVE: To describe disease course, histopathology, and outcomes for infants with atypical presentations of alveolar capillary dysplasia with misalignment of the pulmonary veins (ACDMPV) who underwent bilateral lung transplantation. STUDY DESIGN: We reviewed clinical history, diagnostic studies, explant histology, genetic sequence results, and post-transplant course for 6 infants with atypical ACDMPV who underwent bilateral lung transplantation at St. Louis Children's Hospital...
November 30, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/29177193/percutaneous-management-of-a-pyocystic-fistulizing-continent-urinary-diversion
#5
Michael C Phung, Benjamin R Lee, Joel T Funk
Background: Continent diversions have since been performed with increasing frequency since the 1950s, with some providers espousing the use of orthotopic diversions as being the new gold standard. However, patients must be counseled to take great care in the maintenance of their diversions because of complications such as metabolic abnormalities, pouch stones, and mucus retention. Case Report: A 21-year-old male with a history of posterior urethral valves underwent a continent catheterizable diversion as a child...
2017: Journal of Endourology Case Reports
https://www.readbyqxmd.com/read/29159472/current-strategies-to-predict-and-manage-sequelae-of-posterior-urethral-valves-in-children
#6
Aniruddh V Deshpande
Posterior urethral valves (PUV) constitute a significant urological cause of chronic kidney disease (CKD) in children. The condition is characterised by the unique pathophysiology of the evolution of bladder dysfunction after relief of obstruction, which contributes to CKD. Improvements in prenatal diagnosis followed by selective foetal intervention have not yet produced improvement in long-term renal outcomes, although better patient selection may alter this in the future. Proactive management with surveillance, pharmacotherapy, timed voiding, double voiding, and/or assisted bladder-emptying, is being increasingly offered to those with severe bladder dysfunction and has the potential of reducing the burden of renal disease...
November 20, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/29110519/caring-for-infants-with-posterior-urethral-valves-a-qualitative-study-of-parents-experiences
#7
Sarah Marokakis, Nadine A Kasparian, Sean E Kennedy
This study aimed to explore the perspectives and experiences of parents caring for an infant with posterior urethral valves (PUVs). Eight parents participated in a semi-structured, individual telephone interview, with qualitative data collected and analysed thematically using NVivo11 software. Two main themes emerged as interconnecting aspects of parents' experiences: (1) trying to face the challenges and (2) learning to cope. Parents felt challenged by the need to attend to their child's medical care, while developing a bond with their baby, trying to maintain positivity for their child's future and managing the impact of the condition on their family...
January 1, 2017: Journal of Child Health Care: for Professionals Working with Children in the Hospital and Community
https://www.readbyqxmd.com/read/29082641/risk-factors-for-urological-complications-following-living-donor-renal-transplantation-in-children
#8
Mohammed S ElSheemy, Waleed Ghoneima, Waseem Aboulela, Kareem Daw, Ahmed M Shouman, Ahmed I Shoukry, Sherif Soaida, Doaa M Salah, Hafez Bazaraa, Fatina I Fadel, Ahmed A Hussein, Enmar Habib, Ismail R Saad, Mohamed El Ghoneimy, Hany A Morsi, Mohammed A Lotfi, Hesham Badawy
The aim of this study was to detect possible risk factors for UC and UTI following pediatric renal Tx and effect of these complications on outcome. One hundred and eight children who underwent living donor Tx between 2009 and 2015 were retrospectively included. Extraperitoneal approach was used with stented tunneled extravesical procedure. Mean recipient age was 9.89 ± 3.46 years while mean weight was 25.22 ± 10.43 kg. Seventy-three (67.6%) recipients were boys while 92 (85.2%) were related to donors...
October 29, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/29071146/posterior-urethral-valves-impact-of-low-birth-weight-and-preterm-delivery-on-the-final-renal-outcome
#9
Osama M Sarhan
OBJECTIVE: To investigate the relationship between low birth weight (LBW; <2.5 kg) and preterm delivery (<37 weeks gestational age) and final renal outcome in infants with posterior urethral valves (PUVs), emphasising the risk factors for the development of chronic kidney disease (CKD). PATIENTS AND METHODS: A retrospective review was performed for all infants with PUVs who were treated between 1990 and 2010. In all, 52 infants were identified to have LBW and/or delivered preterm (Group 1)...
June 2017: Arab Journal of Urology
https://www.readbyqxmd.com/read/29067525/hypernatremia-and-acute-pancreatitis-in-chronic-kidney-disease-back-to-the-salt-mines-questions
#10
Marie de Tersant, Thérésa Kwon, Marie-Alice Macher, Anne Maisin, Georges Deschênes, Olivier Niel
BACKGROUND: Acute pancreatitis can be a life-threatening complication in patients with chronic kidney disease (CKD), especially in kidney transplant recipients. CASE DIAGNOSIS/TREATMENT: The patient was 7 years old when he received renal transplantation for CKD secondary to posterior urethral valves. Two years later, he presented with severe necrotizing pancreatitis (Ranson's score 5, Balthazar's score 8). Viral and genetic testing came back negative; pancreatitis was attributed to the patient's treatments (prednisone, trimethoprim-sulfamethoxazole, and everolimus)...
October 24, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/29061539/impact-of-adjuvant-urinary-diversion-versus-valve-ablation-alone-on-progression-from-chronic-to-end-stage-renal-disease-in-posterior-urethral-valves-a-single-institution-15-year-time-to-event-analysis
#11
Michael E Chua, Jessica M Ming, Simon Carter, Yaser El Hout, Martin A Koyle, Damien Noone, Walid A Farhat, Armando J Lorenzo, Darius J Bägli
PURPOSE: Long-term progression to end-stage renal disease (ESRD) of valve ablation alone versus ablation followed by additional urinary diversion were compared among children with chronic kidney disease stage 3 (CKD3) due to posterior urethral valves (PUV). MATERIALS AND METHODS: A retrospective study of children with PUV and CKD3 managed at a single institution between 1986 and 2011. Three treatment groups were classified: Group1 (valve ablation alone), group2 (ablation plus subsequent vesicostomy), and group3 (ablation followed by ureterostomies and/or pyelostomies)...
October 20, 2017: Journal of Urology
https://www.readbyqxmd.com/read/29028084/expression-and-clinical-significance-of-aquaporin-1-and-et-1-in-urine-of-children-with-congenital-hydronephrosis
#12
Y Yu, Y-F Kang, K-S Li, Z-H Chen, L Zhang, H-M Zhang, M Zhang
OBJECTIVE: Congenital hydronephrosis is induced by congenital obstruction of uretero pelvic junction, bladder vesicoureteral reflux, posterior urethral valve, stricture of ureter end and ureterocyst, which is extremely apt to cause end-stage renal failure in children. It becomes significant to explore the expression profile and clinical significance of aquaporin-1 (AQP-1) and ET-1 (endothelin-1) in the urine of children with congenital hydronephrosis. PATIENTS AND METHODS: 80 cases of children with congenital hydronephrosis were selected to be the observation group and another 40 cases of children with other diseases were served as control group...
September 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28901936/advances-in-paediatric-urology
#13
REVIEW
David A Diamond, Ivy H Y Chan, Andrew J A Holland, Michael P Kurtz, Caleb Nelson, Carlos R Estrada, Stuart Bauer, Paul K H Tam
Paediatric urological surgery is often required for managing congenital and acquired disorders of the genitourinary system. In this Series paper, we highlight advances in the surgical management of six paediatric urological disorders. The management of vesicoureteral reflux is evolving, with advocacy ranging from a less interventional assessment and antimicrobial prophylaxis to surgery including endoscopic injection of a bulking agent and minimally invasive ureteric reimplantation. Evidence supports early orchidopexy to improve fertility and reduce malignancy in boys with undescended testes...
September 9, 2017: Lancet
https://www.readbyqxmd.com/read/28770138/anterior-urethral-valve-uncommon-association-with-renal-duplicity
#14
Amina Ben Salem, Ines Mazhoud, Rachida Laamiri, Randa Salem, Hayet Laajili, Lassaad Sahnoun, Chiraz Hafsa
Anterior urethral valves (AUVs) is an unusual cause of congenital obstruction of the male urethra, being 15-30 times less common than posterior urethral valves. We present a case of AUV diagnosed at 24th gestational week. Ultrasonography and fetal MRI revealed hydronephrotic kidneys with ureteral duplicity, a distended bladder and perineal cystic mass which confirmed dilated anterior urethra in a male fetus. Diagnosis was confirmed postnatally by voiding cystourethrogram and surgery.
April 2017: Journal of Neonatal Surgery
https://www.readbyqxmd.com/read/28768664/preventative-effects-of-a-hif-inhibitor-17-dmag-on-partial-bladder-outlet-obstruction-induced-bladder-dysfunction
#15
Nao Iguchi, M İrfan Dönmez, Anna P Malykhina, Alonso Carrasco, Duncan T Wilcox
Posterior urethral valves are the most common cause of partial bladder outlet obstruction (PBOO) in the pediatric population. Pathological changes in the bladder developed during PBOO are responsible for long-lasting voiding dysfunction in this population despite early surgical interventions. Increasing evidence showed PBOO induces an upregulation of Hypoxia inducible factors (HIFs) and their transcriptional target genes, and they play a role in pathophysiological changes in the obstructed bladders. We hypothesized that blocking HIF pathways can prevent PBOO-induced bladder dysfunction...
August 2, 2017: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/28753736/can-quantity-of-amniotic-fluid-reliably-predict-postnatal-renal-function-in-boys-with-posterior-urethral-valves-a-decision-curve-analysis
#16
Luke Harper, Alice Waubant, Julien Vignes, Sara Amat, Eric Dobremez, Yan Lefevre, Cyril Ferdynus
OBJECTIVE: Prenatal management of male fetuses with suspected posterior urethral valves depends on reliable markers for postnatal long-term renal function. Whether ultrasound parameters, including the presence or absence of oligohydramnios, are reliable remains the subject of debate. We decided to evaluate the reliability of quantity of amniotic fluid to predict postnatal renal function using decision curve analysis (DCA), a method for evaluating the clinical utility of a diagnostic test...
September 2017: Prenatal Diagnosis
https://www.readbyqxmd.com/read/28752084/the-long-term-effect-of-superficial-bladder-neck-incision-on-ejaculation-and-incontinence-in-boys-with-primary-and-secondary-bladder-neck-obstruction
#17
Pauline M L Hennus, Esther Hoenjet, Jan H Kieft, Tom P V M de Jong, Laetitia M O de Kort
OBJECTIVE: Superficial bladder neck incision (SBNI) is controversial at young age, with retrograde ejaculation after puberty as main concern. The aim of the study is to investigate the long-term effect of SBNI on ejaculation and incontinence in boys with primary and secondary bladder neck obstruction (BNO). MATERIALS AND METHODS: In boys with infravesical obstruction, SBNI was performed in case of a persistent BNO after earlier desobstruction or in case of primary severely obstructive bladder neck...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28747615/isolated-congenital-megacystis-with-spontaneous-resolution-a-case-report
#18
Toshihiko Nakamura
The patient was a male infant with an antenatal diagnosis of huge intraabdominal mass. Prenatal ultrasound at 35 weeks gestation revealed a markedly enlarged cystic mass in the lower abdomen. After birth at 38 weeks, the infant was allowed to void spontaneously and passed meconium. Ultrasonography showed an enlarged bladder with wall thickness of 2.9 mm and no hydronephrosis. Voiding cystourethrograms showed no evidence of vesicoureteral reflex and posterior urethral valve. The post-void residuals were 15 mL at 11 days of life, 5 mL at 1 month and 0 mL at 5 months...
August 9, 2017: Fukushima Journal of Medical Science
https://www.readbyqxmd.com/read/28712168/justification-for-re-look-cystoscopy-after-posterior-urethral-valve-fulguration
#19
Gul Nawaz, Ijaz Hussain, Shujah Muhammad, Muhammad Imran Jamil, Asad Ur Rehman, Nadeem Iqbal, Saeed Akhter
BACKGROUND: Posterior urethral valve (PUV) is life-threatening congenital anomaly of the urinary tract that results in vesicoureteric reflux, recurrent UTI, voiding dysfunction and renal insufficiency if not treat timely. Endoscopic ablation of posterior urethral valves using cold knife or laser is the current gold standard therapy. Many urologists go for repeat cystoscopy to see residual valve or stricture while others repeat VCUG to measure the posterior to anterior urethral ratio for residual obstruction...
January 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28700992/natural-history-of-fetal-lower-urinary-tract-obstruction-with-normal-amniotic-fluid-volume-at-initial-diagnosis
#20
Mark P Johnson, Enrico Danzer, Jamie Koh, William Polzin, Chris Harman, Richard O'Shaughnessy, Richard Brown, Michael V Zaretsky
OBJECTIVE: The aim of this study was to define the natural history of lower urinary tract obstruction (LUTO) with normal midgestational amniotic fluid volumes. MATERIALS AND METHODS: We performed a retrospective review of 32 consecutive patients with LUTO with normal midgestational amniotic fluid volume followed at 11 North American Fetal Therapy Network (NAFTNet) centers from August 2007 to May 2012. Normal amniotic fluid volume was defined as an amniotic fluid index (AFI) of ≥9 cm...
July 13, 2017: Fetal Diagnosis and Therapy
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