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Posterior Uretral Valv Olgularında Ürodinamik İzlem

Yıl 2021, , 91 - 96, 25.06.2021
https://doi.org/10.33716/bmedj.917377

Öz

Amaç: Posterior uretral valv hastalığı, yenidoğan döneminden itibaren tedavi edilmediği taktirde komplikasyonlara neden olabilen ağır bir patolojidir. Bu çalışmanın amacı,ürodinaminin posterior uretral valvli olguların izlemindeki yeri ve önemini belirlemektir. Gereç ve Yöntemler: Bu retrospektif çalışmada, Ege Üniversitesi, Tıp Fakültesi, Çocuk Cerrahisi A.D’da 1994-2000 yılları arasında tanı, tedavi ve takibi yapılan 34 PUV olgusunun sonuçları değerlendirilmiştir. Bulgular: Bu retrospektif çalışmaya toplam 34 erkek PUV hastası dahil edilmiştir. Olguların tanı anındaki yaş ortalamaları 46±57 (0-158) aydır. Olguların ortalama izlem süreleri 18±14 (En az 1- En çok 56) aydır. Erken dönemde (0-1 yaş) valv ablasyonu uygulanan 8 olgunun ilk ve 1 yaşındaki ikinci ürodinamik incelemelerinde ölçülen mesane kapasiteleri ve kompliyans değerleri ile beklenen mesane kapasiteleri ve kompliyans değerleri arasında istatistiksel olarak anlamlı fark saptanmıştır (p<0.05). Olgulara uygulanan en az iki ürodinamik inceleme sırasında ölçülen işeme basınç değerleri arasında azalma olduğu gözlenmiş ve bu sonuç istatistiksel olarak anlamlı bulunmuştur (p<0.05). Olgulara miksiyosistoüretrografi sonuçlan değerlendirildiğinde üç olguda bilateral, altı olguda tek taraflı VUR (sağ/sol:2/3) saptanmış, 15 olguda VUR saptanmamıştır. Sonuç: Sonuç olarak, posterior uretral valv olgularında valv ablasyonu sonrası tedavi protokolünün belirlenmesi ve izlem açısından; medikal tedavinin etkinliği, detrusorsfınkter ilişkisinin belirlenmesi, basınç- volüm kompliyans gibi parametrelerle matematiksel olarak değerlendirilmesi ve üst üriner traktüs için risk meydana getirebilecek değişikliklerin önceden belirlenebilmesi için ürodinamik izlem etkili bir yöntemdir.

Destekleyen Kurum

yok

Kaynakça

  • Holmdahl G, Sillen U, Bachelard M, Hansson E, Hennansson G, Hjalmas K. The changing urodynamic pattem in valve bladders during infancy. J Urol 153: 463-467, 1995.
  • De Gennaro M, Capitanucci M, Capozza N, Caione P, Mosiello G, Silveri M. Detrusor hypocontractility in children with posterior urethral valves arises before puberty. British Journal of Urology (81),Suppl, 3, 81-85, 1998.
  • Ulman İ, Avanoğlu A, Gökdemir A. Pediatrik ürodinami workshop. 11-45, Ekim 1995.
  • Podesta ML, Ruarte A, Gargıulo C, Medel R, Castera R. Urodynamic findings in boys with posterior urethral valves after treatment with valve ablation or vesicostomy and delayed ablation. The Joumal of Urology Vol. 164 139-144, July 2000.
  • De Gennaro M, Mosiello G, Capitanucci ML, Silveri M, Capozza N, Caione P. Early detection of bladder dysfunction following posterior urethral valves ablation. Eur J Pediatr Surg 6 163-165,1996.
  • Kim YH, Horowitz M, Combs A, Nitti VW, Libretti D, Glassberg. KI. Comparative urodynamic findings after primary valve ablation, vesicostomy or proximal diversion. The Journal of Urology Vol. 156, 673-676, August 1996.
  • Kim YH, Horowitz M, Combs AJ, Nitti VW, Borer J, Glassberg Kenneth I. Management of posterior urethral valves on the hasis of urodynamic findings. The Journal of Urology vol. 158, 1O11-1O16, September 1997.
  • Dinneen MD, Duffy PG. Posterior urethral valves. British Journal of urology (78), 275-281, 1996.
  • Walker RD, Padron M. The management of posterior urethral valves by initial vesicostomy and delayed valve ablation. J Ural., 144: 1212, 1990.
  • Lal R, Bhatnagar V, Mitra DK. Long-term prognosis of renal function in boys treated for posterior urethral valves. Eur J Pediatr Surg 9 307-311,1999.
  • Pflster CH, Wagner L, Dacher JN, Liard B, Boillot B, Mitrofanoff P. Long-term bladder dysfunction in boys with posterior urethral valves. Eur J Pediatr Surg 6 222-224, 1996.
  • Greeley C, Snell J, Colaco A, Beatey J, Bailey J, Bjorn S, Rifai N, Hicks J, Soldin SJ. Pediatric referance ranges for electrolytes and creatinine. Clin Chem, 39: 1172, 1993.
  • Workman SJ, Kogan BA Fetal bladder histology ın posterior urethral valves and prune belly syndrome. J Urology 144: 337-339, 1990.
  • Peters CA, Vasavada S, Dator CM, Shapiro E, Lepor H, McConnell J, Retik AB, Mandell J. The effect of obstruction on the developing bladder. J Urology: Vol. 148, 491-496,1992.
  • Holmdahl G, Sillen U, Hanson E, Hermansson G, Hjalınas K. Bladder dysfunction in boys with posterior urethral valves before and after puberty. J Urol 155: 694-698, 1996.
  • Nijman RJM. Urodynamic implications of posterior urethral valve management. XIV: Ulusal Çocuk Cerrahisi Kongresi. Bildiri özetleri, C3, Eylül 1995
  • Joseph DB. Editorial: Posterior urethral valves and The 11 th Commandment. The Joumal of Urology Vol. 164, 149-150, July 2000.
  • Peters CA, Bolkier M, Bauer SB, Hendren WH, Colodny AH, Mandel J, Retik AB. The urodynamic consequences of posterior urethral valves. The Joumal of Urology: Vol. 144, 122-126, July 1990.
  • Ziylan O, Ander H, Koçak T, Nane İ, Orhan İ. Valv mesanesi: Posterior uretral valvde ürodinami bulguları. Türk Üroloji Dergisi. Kongre özel sayısı. 34, 1996.
  • Parkhouse HF, Barratt TM, Dillon MJ, Duffy PG, Fay J, Ransley PG, Woodhouse RJ, Williams DI. Long-term outcome of boys with posterior urethral valves. Br J Ural. 62: 59-62, 1988.
  • Lal R, Bhatnagar V, Agarwala S, Grover VP, Mitra DK. Urodynamic evaluation in boys treated for posterior urethral valves. Pediatr Surg Int 15: 358-362, 1999.

Urodynamic Follow-Up In Posterior Uretral Valv Cases

Yıl 2021, , 91 - 96, 25.06.2021
https://doi.org/10.33716/bmedj.917377

Öz

Aim: Posterior urethral valve disease is a severe pathology that can cause complications if not treated from the neonatal period. The aim of this study is to determine the place and importance of urodynamy in the follow-up of cases with posterior urethral valve. Material and Method: In this retrospective study, we evaluated a total 34 patients diagnosed, treated and followed-up with PUV between 1994-2000 in the Department of Pediatric Surgery, School of Medicine, Ege University. Result: A total of 34 male patients with PUV were included in this retrospective study. The mean age of the cases at the time of diagnosis was 46±57 (0-158) months. The mean follow-up period of the cases was 18±14 (minimum 1-maximum 56) months. There were a statistically significant difference between measured and the expected bladder capacities and compliance values in the first and 1-year-old (2nd) urodynamic examinations of 8 patients who underwent valve ablation in the early period (0-1 years) (p<0.05). There was a decrease in the the values of voiding pressure measured during at least two urodynamic examinations applied to the cases (p<0.05). During the cystourethrography examination, bilateral VUR (right/ left:2/3) in three cases and unilateral VUR in six cases, and VUR was not detected in 15 cases. Conclusion: In terms of determining the treatment protocol and follow-up after valve ablation in patients with posterior urethral valve; Urodynamic monitoring is an effective method to determine the effectiveness of medical treatment, the detrusor-sphincter relationship and to allow the mathematically calculation with parameters such as pressure-volume compliance, and to predetermine changes that may pose a risk for the upper urinary tract.

Kaynakça

  • Holmdahl G, Sillen U, Bachelard M, Hansson E, Hennansson G, Hjalmas K. The changing urodynamic pattem in valve bladders during infancy. J Urol 153: 463-467, 1995.
  • De Gennaro M, Capitanucci M, Capozza N, Caione P, Mosiello G, Silveri M. Detrusor hypocontractility in children with posterior urethral valves arises before puberty. British Journal of Urology (81),Suppl, 3, 81-85, 1998.
  • Ulman İ, Avanoğlu A, Gökdemir A. Pediatrik ürodinami workshop. 11-45, Ekim 1995.
  • Podesta ML, Ruarte A, Gargıulo C, Medel R, Castera R. Urodynamic findings in boys with posterior urethral valves after treatment with valve ablation or vesicostomy and delayed ablation. The Joumal of Urology Vol. 164 139-144, July 2000.
  • De Gennaro M, Mosiello G, Capitanucci ML, Silveri M, Capozza N, Caione P. Early detection of bladder dysfunction following posterior urethral valves ablation. Eur J Pediatr Surg 6 163-165,1996.
  • Kim YH, Horowitz M, Combs A, Nitti VW, Libretti D, Glassberg. KI. Comparative urodynamic findings after primary valve ablation, vesicostomy or proximal diversion. The Journal of Urology Vol. 156, 673-676, August 1996.
  • Kim YH, Horowitz M, Combs AJ, Nitti VW, Borer J, Glassberg Kenneth I. Management of posterior urethral valves on the hasis of urodynamic findings. The Journal of Urology vol. 158, 1O11-1O16, September 1997.
  • Dinneen MD, Duffy PG. Posterior urethral valves. British Journal of urology (78), 275-281, 1996.
  • Walker RD, Padron M. The management of posterior urethral valves by initial vesicostomy and delayed valve ablation. J Ural., 144: 1212, 1990.
  • Lal R, Bhatnagar V, Mitra DK. Long-term prognosis of renal function in boys treated for posterior urethral valves. Eur J Pediatr Surg 9 307-311,1999.
  • Pflster CH, Wagner L, Dacher JN, Liard B, Boillot B, Mitrofanoff P. Long-term bladder dysfunction in boys with posterior urethral valves. Eur J Pediatr Surg 6 222-224, 1996.
  • Greeley C, Snell J, Colaco A, Beatey J, Bailey J, Bjorn S, Rifai N, Hicks J, Soldin SJ. Pediatric referance ranges for electrolytes and creatinine. Clin Chem, 39: 1172, 1993.
  • Workman SJ, Kogan BA Fetal bladder histology ın posterior urethral valves and prune belly syndrome. J Urology 144: 337-339, 1990.
  • Peters CA, Vasavada S, Dator CM, Shapiro E, Lepor H, McConnell J, Retik AB, Mandell J. The effect of obstruction on the developing bladder. J Urology: Vol. 148, 491-496,1992.
  • Holmdahl G, Sillen U, Hanson E, Hermansson G, Hjalınas K. Bladder dysfunction in boys with posterior urethral valves before and after puberty. J Urol 155: 694-698, 1996.
  • Nijman RJM. Urodynamic implications of posterior urethral valve management. XIV: Ulusal Çocuk Cerrahisi Kongresi. Bildiri özetleri, C3, Eylül 1995
  • Joseph DB. Editorial: Posterior urethral valves and The 11 th Commandment. The Joumal of Urology Vol. 164, 149-150, July 2000.
  • Peters CA, Bolkier M, Bauer SB, Hendren WH, Colodny AH, Mandel J, Retik AB. The urodynamic consequences of posterior urethral valves. The Joumal of Urology: Vol. 144, 122-126, July 1990.
  • Ziylan O, Ander H, Koçak T, Nane İ, Orhan İ. Valv mesanesi: Posterior uretral valvde ürodinami bulguları. Türk Üroloji Dergisi. Kongre özel sayısı. 34, 1996.
  • Parkhouse HF, Barratt TM, Dillon MJ, Duffy PG, Fay J, Ransley PG, Woodhouse RJ, Williams DI. Long-term outcome of boys with posterior urethral valves. Br J Ural. 62: 59-62, 1988.
  • Lal R, Bhatnagar V, Agarwala S, Grover VP, Mitra DK. Urodynamic evaluation in boys treated for posterior urethral valves. Pediatr Surg Int 15: 358-362, 1999.
Toplam 21 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Klinik Tıp Bilimleri
Bölüm ARAŞTIRMA MAKALESİ
Yazarlar

Murat Yılmaz Bu kişi benim 0000-0003-3196-1157

Ahmet Hikmet Şahin 0000-0002-9134-9800

Yayımlanma Tarihi 25 Haziran 2021
Yayımlandığı Sayı Yıl 2021

Kaynak Göster

APA Yılmaz, M., & Şahin, A. H. (2021). Posterior Uretral Valv Olgularında Ürodinamik İzlem. Balıkesir Medical Journal, 5(2), 91-96. https://doi.org/10.33716/bmedj.917377