[Urethral valves and urinary incontinence: bladder function in temporary high diversion].

UNLABELLED

We report on urodynamic follow-up studies in patients (mean age 8.4 years) with posterior urethral valves (PUV), in which the operative management was finished between 1992 and 1997. The initial therapy included valve resection and transurethral or suprapubic vesical diversion.

QUESTION

Does a temporary high diversion have a negative effect on bladder function? Study A was performed at a mean age of 14 months after a high diversion (Sober-non end ureterocutaneostomy) was required for the protection of the dilated upper urinary tract in 7 patients and 13 ureterorenal units. In mean 5.2 years later Study B was performed after undiversion and, in most cases, ureteral reimplantation. In study A the boys with ureterostomy demonstrated higher pathological compliance, capacity and detrusor function. In study B all patients showed improvement of compliance, capacity and detrusor hyperactivity. Surprisingly we found higher values for compliance and capacity in the children with temporary high diversion.

CONCLUSION

Improvement of urodynamic results after valve ablation is possible even after bilateral temporary high diversion (Sober stoma). No 'low compliance-low capacity-bladder' developed.