The Importance of Second Look Cystoscopy after Posterior Urethral Valve Ablation in Children: Single Center Experience

Aboul Ela Waseem Nabil*, Ahmed Salem, Mohamed Salah, Hesham Ibrahim, Mohamed Abdel Ghany, Ashraf Emran, Abdelwahab M, Ahmed Shouman, Ahmed Shokry, Mohamed El Sheemy, Mohamed Elghoneimy, Hany Morsi, Sameeh Zamel and Waleed Ghoneima

Department of Pediatric Urology, Kasr al Ainy, Cairo University, Egypt

^*Correspondance to: Aboul Ela Waseem Nabil 

 PDF  Full Text DOI: 10.25107/2474-1647.2691

Abstract

Objectives: This study was designed to assess the importance of second look cystoscopy after primary ablation of posterior urethral valve in children. Patients and Methods: A prospective study was conducted at Kasr Al Ainy Pediatric Hospital (Aboulreesh), Urology Department, Cairo University on 50 male children, diagnosed to have posterior urethral valve between September 2016 and June 2017. Diagnosis of posterior urethral valve was made by voiding symptoms, ultrasonography and confirmed by voiding cystourethrogram. All children were treated by endoscopic ablation of posterior urethral valve 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 primary valve ablation to see residual valves as a routine procedure irrespective of the improvement in symptoms, ultrasonography or laboratory results. Results: Mean age at presentation was 8.3 ± 12.6 months. The presenting symptoms were acute urine retention in (44%); obstructive symptoms in (42%), recurrent febrile UTI in (10%) and two patients (4%) underwent primary valve ablation based on antenatal diagnosis. 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 before and after valve ablation and the presence of residual valve during 2nd look cystoscopy after 1ry valve ablation except for the age at presentation (p=0.021) and the presence of post-voiding residual urine in post-ablation ultrasound (p=0.035). Conclusion: The 2nd look cystoscopy one month after 1ry valve ablation is important for early detection of any residual obstructive valve irrespective of improvement in the clinical symptoms, ultrasonography, or laboratory results.

Keywords

PUV; Endoscopic valve ablation; Residual valve; 2nd Look cystoscopy

Cite the article

Nabil AEW, Salem A, Salah M, Ibrahim H, Ghany MA, Emran A, et al.. The Importance of Second Look Cystoscopy after Posterior Urethral Valve Ablation in Children: Single Center Experience. Clin Surg. 2019; 4: 2691..