Rojas-Ticona J, Fernández Córdoba M S, Cabezalí Barbancho D, Marijuán Sahuquillo V, Argumosa Salazar Y M, Ramírez Piqueras M, Moratalla Jareño T, Hernández Anselmi E J, Vidal Company A, Parrondo Muiños C
Pediatric Surgery Department. Complejo Hospitalario Universitario de Albacete. Albacete (Spain).
Pediatric Surgery Department, Pediatric Urology Unit. Hospital Universitario 12 de Octubre. Madrid (Spain).
Cir Pediatr. 2020 Jan 20;33(1):36-42.
Report our experience with the use of contrast-enhanced serial voiding urosonography (SVU) for posterior urethral valve (PUV) patient diagnosis and management.
Descriptive retrospective study in 0- to 14-year-old patients with suspected PUV at SVU performed as a first contrast-enhanced urinary tract test with subsequent cystoscopic study. Variables were analyzed using SPSSv22.
18 patients were studied (median age: 6 months). Most patients (15) presented posterior urethral dilatation (mean diameter: 9.56 mm) and a >2 mm gap between proximal and distal urethra. 13 cases had bladder thickening and 9 had VUR. 15 PUV cases, 1 case of distal urethral mucocele, and 1 case of bladder diverticulum obstructing the urethra were diagnosed. Complete PUV resection was performed in 10 patients (66.6%) at the first cystoscopy. The control SVU detected one case of recurrence due to persistence of posterior urethral dilatation. The recurrence case and the 5 incomplete resection cases were treated with a second cystoscopy and resection. The youngest patients required a third resection and cutting balloon dilatation due to residual stenosis. Mean creatinine levels at diagnosis were 0.28 mg/dl.
Serial voiding urosonography (SVU) is a useful complementary test in pediatric patients with posterior urethral valve. Its dynamic nature and its advantages - absence of irradiation, safety, and high sensitivity - make it an ideal imaging test for PUV diagnosis and follow-up.
报告我们使用对比增强连续排尿超声检查（SVU）对后尿道瓣膜（PUV）患者进行诊断和管理的经验。
对0至14岁疑似PUV的患者进行描述性回顾性研究，将SVU作为首次对比增强尿路检查，随后进行膀胱镜检查。使用SPSSv22分析变量。
共研究了18例患者（中位年龄：6个月）。大多数患者（15例）出现后尿道扩张（平均直径：9.56毫米），近端和远端尿道之间间隙>2毫米。13例患者有膀胱增厚，9例有膀胱输尿管反流（VUR）。诊断出15例PUV、1例远端尿道黏液囊肿和1例膀胱憩室阻塞尿道。10例患者（66.6%）在首次膀胱镜检查时进行了PUV完全切除术。对照SVU检测到1例因后尿道扩张持续存在而复发的病例。复发病例和5例不完全切除病例接受了第二次膀胱镜检查和切除术。最年幼的患者因残留狭窄需要第三次切除和切割球囊扩张术。诊断时的平均肌酐水平为0.28毫克/分升。
连续排尿超声检查（SVU）是小儿后尿道瓣膜患者有用的辅助检查。其动态特性及其优点——无辐射、安全且灵敏度高——使其成为PUV诊断和随访的理想影像学检查。
