Abstract：Objective: To investigate the urodynamic characteristics of children with posterior urethral valves (PUV) subject to bladder neck incision. Methods: A total of 56 children with a diagnosis of PUV during July 2012 to May 2016 after ablation of PUV were studied, and the average ages were (2.0±0.8) years old. The patients were categorized under 2 main groups. In the group 1 (n=13, 2012.7-2013.7), the average ages were (1.8±0.6) years old. In the group 2 (n=43, 2013.8-2016.5), the average ages were (2.3±0.9) years old. They were examined by ultrasonography, MRU, ECT and VCUG before the operation. The anterior urethral valve existed in 2 children. All children in these groups had different degrees of urologic concomitancy UVJO (36, 64.3%) and vesicoureteral reflux (23, 41.1% higher than Ⅲ°). The urodynamic results were compared between two groups pre-operation and beyond half a year post-operation. Results: After the operation, they were diagnosed by ultrasonography and urodynamic studies (UDS). There were no significant changes in Pdetmax in 8 patients in the group 1, who underwent bladder neck incision only, so we did the second cystoscopy, and it was found that the valve structure had been cleared, but the bladder neck was elevated significantly, then we did the bladder neck incision. Pdetmax and uroflowmetry (UFM) were improved significantly later. In the group 2, children with elevated bladder neck underwent valve ablation/bladder neck incision. In the group 2, the Pdetmax and PVR were (42.2 ± 14.1) cm H2O and (21.6 ± 12.4) mL respectively, lower than those [(75.1 ± 18.3) cm H2O and PVR (32.8 ± 8.9) mL] in the group 1. In the group 2, the MBC and BC were (90.4 ± 33.7) mL and (9.5 ± 2.4) mL/cm H2O respectively, higher than those [(73.1 ±20.1) mL and (6.4 ± 1.9) mL/cm H2O] in the group one. In group two, UFM was (7.9 ± 0.7) mL/s, higher than (5.6±2.0) mL/s in the group 1. There was no urinary incontinence in all children and voiding symptoms were significantly improved in the group two then in the group 1. Differences in the above-mentioned five parameters were significnat between two groups (P<0.05), while there was no significant difference in DI (P>0.05). Conclusions: In children with PUV in combination with elevated bladder neck, valve ablation/bladder neck incision at the same time can significantly reduce the pressure inside the bladder. Urodynamic examination can detect bladder dysfunction and guide the next step. Therefore, in children with PUV, the bladder function should be cheched to protect the upper urinary tract.
周晓光, 周辉霞, 马立飞, 刘德鸿, 曹华林, 陶天, 罗小龙, 陈绍君. 后尿道瓣膜症幼儿行膀胱颈切开术的尿动力学检查临床分析[J]. 微创泌尿外科杂志, 2017, 6(4): 235-238.
Zhou Xiaoguang, Zhou Huixia, Ma Lifei, Liu Dehong, Cao Hualin, Tao Tian, Luo Xiaolong, Chen Shaojun. Urodynamics of children with posterior urethral valves subject to bladder neck incision. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2017, 6(4): 235-238.
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