Mechanical Ablation of the Posterior Urethral Valve Omitting Thermal Energy: A Brief Report.

IF 1.6 Q2 MEDICINE, GENERAL & INTERNAL Iranian Journal of Medical Sciences Pub Date : 2023-09-01 DOI:10.30476/IJMS.2022.95313.2660
Farzaneh Sharifiaghdas, Narjes Saberi
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Abstract

Management of the posterior urethral valve (PUV) is a clinical challenge in pediatric urology. We report the results of a modified valve ablation method without using a pediatric resectoscope and thermal energy. Patients were selected from children with PUV who were referred to the pediatric urology clinic of Shahid Labbafinejad Hospital, Tehran, Iran, and have undergone endoscopic valve ablation surgery between May 2019 to May 2021. Ten male patients with PUV underwent mechanical valve ablation without the use of the conventional pediatric resectoscope, and thermal energy was replaced by a 6F semi-rigid urethroscope and 3Fr ureteral catheter. Patients were assessed both pre-and postoperatively using serum creatinine, urinary tract ultrasound imaging, and voiding cystourethrography. The mean age was 23.88±30.13 months (range= 25 days to 8 years). Four out of 10 patients (40%) had elevated serum creatinine, and seven had unilateral or bilateral hydroureteronephrosis (70%). No major complications were reported according to Clavien-Dindo Classification System. The level of serum creatinine, the grade of hydroureteronephrosis, and the ratio of the prostatic urethra to anterior urethra diameter in postoperative voiding cystourethrography were decreased. A decrease in serum creatinine level occurred in patients after valve ablation, but this decrease was not statistically significant (P=0.059). The decrease in hydroureteronephrosis grade on the right (P=0.006) and left (P=0.022) was statistically significant. There was no evidence of urethral stenosis or need for repeating resection. It can be concluded that our mechanical valve ablation method might be a safe and effective technique for PUV ablation.

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省略热能的后尿道瓣膜机械消融:一份简要报告。
后尿道瓣膜(PUV)的管理是儿科泌尿外科的一个临床挑战。我们报告了一种改良的瓣膜消融方法的结果,该方法不使用儿科切除镜和热能。患者选自PUV儿童,这些儿童被转诊至伊朗德黑兰Shahid Labbafinejad医院的儿科泌尿外科诊所,并在2019年5月至2021年5月期间接受了内窥镜瓣膜消融手术。10名男性PUV患者在不使用传统儿科切除镜的情况下进行了机械瓣膜消融,并用6F半刚性尿道镜和3Fr输尿管导管代替热能。患者在术前和术后均使用血清肌酐、尿路超声成像和排尿膀胱尿道造影进行评估。平均年龄为23.88±30.13个月(25天至8岁)。10名患者中有4名(40%)血清肌酐升高,7名患者患有单侧或双侧输尿管积水性肾病(70%)。根据Clavien-Dindo分类系统,未报告重大并发症。术后排尿膀胱尿道造影中血清肌酐水平、输尿管水性肾病分级以及前列腺尿道与前尿道直径的比值均降低。瓣膜消融术后患者血清肌酸酐水平下降,但这种下降没有统计学意义(P=0.059)。右侧(P=0.006)和左侧(P=0.022)的输尿管积水性肾病分级下降具有统计学意义。没有证据表明尿道狭窄或需要再次切除。可以得出结论,我们的机械瓣膜消融方法可能是一种安全有效的PUV消融技术。
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来源期刊
Iranian Journal of Medical Sciences
Iranian Journal of Medical Sciences MEDICINE, GENERAL & INTERNAL-
CiteScore
3.20
自引率
0.00%
发文量
84
审稿时长
12 weeks
期刊介绍: The Iranian Journal of Medical Sciences (IJMS) is an international quarterly biomedical publication, which is sponsored by Shiraz University of Medical Sciences. The IJMS intends to provide a scientific medium of com­muni­cation for researchers throughout the globe. The journal welcomes original clinical articles as well as clinically oriented basic science re­search experiences on prevalent diseases in the region and analysis of various regional problems.
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