الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
 |  | from | 155 |  |  |
| | | from | 155 | | |
Abstract
Posterior urethral valves (PUVs) represent the commonest form of congenital urinary tract obstruction. The incidence of PUVs is around 1/4000 male infants. Despite the advances in diagnosis and management of PUVs in the last few decades, long-term follow-up of PUVs patients showed that PUVs commonly cause chronic kidney disease (CKD) and end-stage renal disease (ESRD).
The aim of this work was to study the short- and long-term clinical, laboratory, radiological and urodynamic outcomes after ablation of PUVs in a cohort of Egyptian boys. The study was conducted on 45 boys who had PUVs ablation and were followed-up in the Nephrology Clinic of Alexandria University Children’s Hospital. The study comprised two groups of patients:
group I (short-term study) included 15 patients who had PUVs ablation less than one year prior to enrollment in the study. They were followed-up till the end of one year after the operation.
group II (long-term study) included 30 patients who had PUVs ablation 3 years or more prior to enrollment in the study (mean 5.7 ± 3.4 years, range 3-12.9 years).
The study included the history taking, physical examination, routine blood and urine tests, estimated glomerular filtration rate (eGFR), renal and bladder ultrasonography, voiding cystourethrogram (VCUG) and urodynamic studies (UDS: free uroflowmetry and filling and voiding cystometry). The UDS was done for all patients in group II and for only 3 patients in group I, who were above 3 years of age.
The following results were obtained
I- Presentation and nadir serum creatinine
1. Sixteen patients (35.6%) were suspected antenatally.
2. The mean age at diagnosis of those who were diagnosed postnatally was 16.9 ± 31.7 months (median 4 months, range 0 – 120 months). Most (82.2%) of the patients were diagnosed before the age of 1 year.
3. The most common presenting symptoms were obstructive symptoms, in 25 (55.6%) of the patients.
4. The majority of the patients had elevated serum creatinine (76.7%), low serum bicarbonate (83.3%), proteinuria (66.6%) and anemia (69%). About half of the patients had acidosis, wide anion gap, hyperuricemia and abnormal serum sodium level.