Effect of overnight bladder drainage on posterior urethral valve sequelae: A randomized controlled trial.

Abstract

Introduction: Posterior urethral valves may lead to persistent hydronephrosis (HN) and bladder dysfunction despite successful endoscopic valve ablation (EVA).

Objectives: To evaluate the effect of overnight bladder drainage (OBD) on upper urinary tracts and bladders of boys post EVA.

Materials and methods: Boys who had persistent HN after EVA were included. Patients were randomly allocated into OBD or no OBD groups. Timed voiding, anticholinergics and antibiotic prophylaxis were offered for both groups. After 12 months, patients were evaluated for compliance to OBD, daytime continence, febrile urinary tract infections (UTIs), renal function by serum creatinine and ^99mTc-dimercaptosuccinic acid scan, HN, vesicoureteral reflux (VUR) and bladder morphology assessed by ultrasound and voiding cystourethrogram.

Results: Ninety-nine patients; 47 underwent OBD while 52 had no OBD, completed 12 months of follow-up. Compliance to OBD was reported in 87.04 %. OBD group showed significant improvement in daytime continence, HN, VUR, bladder capacity and outline. However, febrile UTIs, renal function affection, bladder wall thickness and post-void urine residual were comparable between both groups.

Conclusions: OBD might improve daytime continence, HN, VUR and abnormal bladder morphology that persist after EVA with no subsequent febrile UTIs or renal function affection. Yet, compliance to OBD remains a matter of concern.