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患有瓣膜膀胱综合征男孩的输尿管膀胱成形术——这种方法仍然适用吗?

Ureterocystoplasty in Boys with Valve Bladder Syndrome-Is This Method Still up to Date?

作者信息

Hofmann Aybike, Ioannou Alexandros, Zöhrer Pirmin Irenaeus, Rösch Wolfgang H

机构信息

Department of Pediatric Urology in Cooperation with University Medical Center Regensburg, Hospital Barmherzige Brüder, Clinic St. Hedwig, 93049 Regensburg, Germany.

Department of Pediatric Surgery, Hospital Barmherzige Brüder, Clinic St. Hedwig, 93049 Regensburg, Germany.

出版信息

Children (Basel). 2023 Apr 6;10(4):692. doi: 10.3390/children10040692.

Abstract

Boys with valve bladder syndrome (PUV) require adequate treatment of the lower urinary tract to preserve renal function and improve long-term outcomes. In some patients, further surgery may be necessary to improve bladder capacity and function. Ureterocytoplasty (UCP) is usually carried out with a small segment of intestine or, alternatively, with a dilated ureter. Our aim was to evaluate the long-term outcomes after UCP in boys with PUV. UCP had been performed in 10 boys with PUV at our hospital (2004-2019). Pre- and postoperative data were evaluated in relation to kidney and bladder function, the SWRD score, additional surgery, complications, and long-term follow-up. The mean time between primary valve ablation and UCP was 3.5 years (SD ± 2.0). The median follow-up time was 64.5 months (IQR 36.0-97.25). The mean increase in age-adjusted bladder capacity was 25% (from 77% (SD ± 0.28) to 102% (SD ± 0.46)). Eight boys micturated spontaneously. Ultrasounds showed no severe hydronephrosis (grade 3-4). The SWRD score showed a median decrease from 4.5 (range 2-7) to 3.0 (range 1-5). No conversion of augmentation was required. UCP is a safe and effective approach to improve bladder capacity in boys with PUV. In addition, the possibility of micturating naturally is still maintained.

摘要

患有瓣膜膀胱综合征(PUV)的男孩需要对下尿路进行充分治疗,以保护肾功能并改善长期预后。在一些患者中,可能需要进一步手术来改善膀胱容量和功能。输尿管膀胱成形术(UCP)通常采用一小段肠道进行,或者也可采用扩张的输尿管。我们的目的是评估PUV男孩接受UCP后的长期预后。我院对10例PUV男孩实施了UCP(2004年至2019年)。对术前和术后的数据进行了评估,内容涉及肾脏和膀胱功能、SWRD评分、额外手术、并发症以及长期随访。初次瓣膜消融与UCP之间的平均时间为3.5年(标准差±2.0)。中位随访时间为64.5个月(四分位间距36.0 - 97.25)。年龄校正后的膀胱容量平均增加了25%(从77%(标准差±0.28)增至102%(标准差±0.46))。8名男孩能够自主排尿。超声检查显示无严重肾积水(3 - 4级)。SWRD评分的中位数从4.5(范围2 - 7)降至3.0(范围1 - 5)。无需进行扩大膀胱术的转换。UCP是一种安全有效的方法,可改善PUV男孩的膀胱容量。此外,自然排尿的可能性仍然得以维持。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a9f6/10136968/42e5800336d5/children-10-00692-g001.jpg

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