WOFAPS 2025 8th World Congress of Pediatric Surgery

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Poster - 78

The posterior urethral valve : is it possible to improve vesico-sphincter dysfunction by early ablation

Fatma Hadjou Belaid 1, Hammou Benslimane 1, Tahar Guezzi 2, Faycel Hamidou 1, Hafida Haouari 1
1 Etablissement hospitalier spécialisé en pédiatrie de Canastel - Oran ­Algérie
2 Centre hospitalo -universtaire de Belabess - Algérie

Purpose :Posterior urethral valves are the most common cause of congenital obstructive uropathy which will alter the bladder filling and emptying function leading to renal failure in childhood. The aim of this study was to evaluate the contribution of early ablation of post-urethral valves on the improvement of bladder dynamics in children

Materials and Methods : Postnatal monitoring of 50 antenatal renal dilations revealed 40 postnatal urethral valves, valve ablation was performed during the neonatal period in 22 of them (Group 1) , the second group at the age of 1 year. Post-operative follow-up of the incidence of bladder dysfunction in the 2 groups assessed on clinical grounds, ultrasound, urethrocystography and urodynamics , At age 3 years voiding diary and toilet training results were obtained.

Results: The mean follow-up was 3 years. Post-void residual improved in 20 patients (87.5%) in group 1, 12 (62.5%) in group 2, vesicoureteral reflux initially present in 24 renal units (group 1), disappeared in 12, improved in 08, reflux present in 28 units (group 2) is improved in 15. Bladder capacity was 147 ± 22 ml (group 1), comparable to the normal capacity expected at this age. 132 ± 30 ml (group 2) which was significantly lower than to the normal capacity expected at this age.hypocompliance, instability were significantly lower in Group 1 , moreover toilet training was easier with best results for dryness . Overall bladder dysfunction was present in 3 boys (12.5%) in Group 1 and 9 (50%) in Group 2

Conclusions: Neonatal valve ablation allow full and cyclic bladder emptying which preserves its function, improves the uro-nephrological prognosis of the upper urinary tract. This inderlines the importance of routine prenatal screening and an early care from this abnormalitie

Keywords: urinarybladder , urethra, prenataldiagnosis , urinarybladder neck obstruction , urogenital abnormalities

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