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The significance of detrusor wall thickness as a prognostic factor in pediatric bladder outlet obstruction.
MedLine Citation:
PMID:  22974606     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
PURPOSE: The purpose of this study is to determine detrusor thickness as a prognostic factor in posterior urethral valves.
METHODS: The medical information of 41 patients diagnosed with posterior urethral valves at our institute was retrospectively reviewed. The serum creatinine level after bladder decompression, results of ultrasonography, and voiding cystourethrography were compared between groups divided according to the final bladder and renal function. Detrusor thickness was measured using Müller's method.
RESULTS: The median detrusor thickness was 1.3 mm (0.4-2.5 mm). After median 45.6 months (7.2-96.0 months) of follow-up, impaired bladder function (IBF) was observed in 14 patients. In multivariate analysis, detrusor thickness greater than 1.3 mm (odds ratio, 32.6; 95% confidence interval, 3.1-340.6; P = .004) was the only independent risk factor for later IBF. Final renal function impairment developed in 24 patients (58.5%), and 3 patients (7.3%) were diagnosed with end-stage renal disease after median 66.0 months (32.4-133.2 months) of follow-up period. On multivariate analysis, age-specific elevated serum creatinine level at presentation (odds ratio, 11.1; 95% confidence interval, 1.1-112.5; P = .042) was an independent risk factor.
CONCLUSIONS: Detrusor thickness more than 1.3 mm on ultrasonography was an independent prognostic factor for later IBF.
Authors:
Yong Seung Lee; Hyun Jin Jung; Young Jae Im; Chang Hee Hong; Sang Won Han
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of pediatric surgery     Volume:  47     ISSN:  1531-5037     ISO Abbreviation:  J. Pediatr. Surg.     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-09-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0052631     Medline TA:  J Pediatr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1682-7     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Elsevier Inc. All rights reserved.
Affiliation:
Department of Urology and Urological Science Institute, Yonsei University College of Medicine, Seoul 120-752, Korea.
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