Document Detail


The predictive value of a repeat micturating cystourethrogram for remnant leaflets after primary endoscopic ablation of posterior urethral valves.
MedLine Citation:
PMID:  20537589     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: We routinely perform a cystourethroscopy 3 months after initial ablation of posterior urethral valves. The aim of this study was to determine the predictive value of the urethral appearance on preoperative micturating cystourethrogram (MCUG) for further valve resection at check cystoscopy.
PATIENTS AND METHODS: We retrospectively reviewed 31 consecutive boys (aged 4-18 months) who underwent check cystoscopy and repeat MCUG between 2006 and 2008.
RESULTS: Repeat MCUG suggested remnant valves in 10, but no residual leaflets were identified cystoscopically in 4. In 20 boys, the valves appeared completely ablated on MCUG but valve leaflets received further resection in 10. One study was undiagnostic. Residual valves were resected in 83% (5/6) where valves and urethral dilatation were noted on MCUG. Where MCUG suggested either valves or persistent dilatation alone, further resection occurred in 40% (4/10). Remnant leaflets were also present in half of those (7/14) in whom the repeat MCUG had shown complete ablation and resolved/reduced posterior urethral dilatation.
CONCLUSIONS: The positive predictive value of valve leaflets and/or posterior urethral dilatation on repeat MCUG for subsequent resection of valve remnants was 56%; the negative predictive value was 50%. We found repeat MCUG alone imprecise in excluding residual valve tissue and recommend check cystoscopy in all.
Authors:
Naima Smeulders; Erica Makin; Divyesh Desai; Patrick G Duffy; Costa Healy; Peter M Cuckow; Abaraham Cherian; Melanie P Hiorns; Imran Mushtaq
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of pediatric urology     Volume:  7     ISSN:  1873-4898     ISO Abbreviation:  J Pediatr Urol     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-03-02     Completed Date:  2011-06-30     Revised Date:  2012-03-19    
Medline Journal Info:
Nlm Unique ID:  101233150     Medline TA:  J Pediatr Urol     Country:  England    
Other Details:
Languages:  eng     Pagination:  203-8     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.
Affiliation:
Department of Paediatric Urology, Great Ormond Street Hospital NHS Trust, London WC1N 1EH, UK. naima.smeulders@talktalk.net
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MeSH Terms
Descriptor/Qualifier:
Cystoscopy*
Endoscopy*
False Negative Reactions
False Positive Reactions
Humans
Infant
Male
Predictive Value of Tests
Retrospective Studies
Urethral Stricture / pathology*,  surgery*
Urination
Urologic Surgical Procedures*
Comments/Corrections
Comment In:
J Pediatr Urol. 2012 Feb;8(1):115; author reply 116   [PMID:  21616720 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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