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在无进一步出口梗阻的情况下,α受体阻滞剂用于小儿后尿道瓣膜患者瓣膜切除术后的效果。

The effect of use of alpha-blockers in posterior urethral valve pediatric patients postvalve ablation in the absence of further outlet obstruction.

作者信息

Aboulela Waseem Nabil, Eladawy Mahmoud Shoukry, Latif Ahmed Abdel

机构信息

Department of Urology, Cairo University, Cairo, Egypt.

Department of Urology, Fayoum University, Fayoum, Egypt.

出版信息

Urol Ann. 2024 Jul-Sep;16(3):218-220. doi: 10.4103/ua.ua_105_23. Epub 2024 Jul 3.

Abstract

OBJECTIVES

The objectives of this study were to detect whether the use of alpha-blockers in posterior urethral valve (PUV) pediatric patients after valve ablation will improve the persistent obstructive symptoms despite the absence of obstruction and if there are associated side effects of its use.

PATIENTS AND

A prospective, single-blinded randomized study was conducted at the urology department of two hospitals on 50 male children between September 2019 and June 2021 with PUV. All children were treated by endoscopic ablation of PUV using the cold knife and were followed clinically for voiding symptoms and with ultrasonography and laboratory tests. All patients underwent second-look cystoscopy 1 month after primary valve ablation to see residual valves as a routine procedure confirming no remnant of the valve and still complaining of obstructive symptoms. They were divided into two equal groups 25 patients each. Group A was given alpha-blockers and Group B placebo for 1 month.

RESULTS

Marked improvement of obstructive symptoms in Group A reaching about 90% (21 patients), whereas no mentioned improvement in Group B was noticed with no side effects of both medication the alpha-blocker and the placebo during its use.

CONCLUSION

The use of alpha-blockers improves the obstructive symptoms in pediatric patients with PUV after valve ablation and in the absence of any further urethral obstruction with no side effects noticed during the period of its use.

摘要

目的

本研究的目的是检测后尿道瓣膜(PUV)小儿患者在瓣膜切除术后使用α受体阻滞剂是否能改善尽管不存在梗阻但仍持续存在的梗阻症状,以及使用该药物是否有相关副作用。

患者与方法

2019年9月至2021年6月期间,在两家医院的泌尿外科对50名患有PUV的男童进行了一项前瞻性、单盲随机研究。所有儿童均采用冷刀进行PUV内镜切除术,并对排尿症状进行临床随访,同时进行超声检查和实验室检查。所有患者在初次瓣膜切除术后1个月接受二次膀胱镜检查,以查看残余瓣膜,这是一项常规操作,确认无瓣膜残留且仍有梗阻症状。他们被分为两组,每组25例患者。A组给予α受体阻滞剂,B组给予安慰剂,为期1个月。

结果

A组梗阻症状明显改善,达到约90%(21例患者),而B组未观察到改善,且在使用α受体阻滞剂和安慰剂期间均未出现副作用。

结论

在瓣膜切除术后且不存在任何进一步尿道梗阻的情况下,使用α受体阻滞剂可改善PUV小儿患者的梗阻症状,且在使用期间未观察到副作用。

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本文引用的文献

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World J Pediatr. 2011 Aug;7(3):205-16. doi: 10.1007/s12519-011-0289-1. Epub 2011 Aug 7.
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The detrusor muscle: an innocent victim of bladder outlet obstruction.逼尿肌:膀胱出口梗阻的无辜受害者。
Eur Urol. 2007 Jan;51(1):57-66. doi: 10.1016/j.eururo.2006.07.050. Epub 2006 Aug 14.
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Management of prenatally diagnosed uropathies.
Arch Dis Child. 1989 Jan;64(1 Spec No):58-63. doi: 10.1136/adc.64.1_spec_no.58.

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