SPU Main Site  |  Past and Future Meetings
Society For Pediatric Urology

Back to 2019 Abstracts


Posterior urethral valves resection in preterm/low birth weight and full-term neonates: a comparison using objectives perioperative data and long-term outcomes
Paulo R. Moscardi, MD1, Ruben Blachman-Braun, MD2, George A. Ransford, MD2, Angela G. Mittal, MD3, Natalia Ballesteros, MD2, Andrew Labbie, MD2, Alireza Alam, MD2, Mariarita Salvitti, MD2, Rafael Gosalbez, MD2, Miguel A. Castellan, MD2.
1Jackson Memorial Hospital, Miami, FL, USA, 2Nicklaus Children's Hospital, Miami, FL, USA, 3Texas Children's Hospital, Houston, TX, USA.

Background: examine the safety and efficacy of posterior urethral valve ablation during the neonatal period, comparing the outcomes of premature/low birth weight (LBW) and full-term neonates with normal birth weights (NBW).
Methods: retrospective chart review was conducted to identify all neonates (0-28 days of life) treated with valve ablation for posterior urethral valves at our center from 2005 to 2014. Patients were further divided in 2 groups: group 1 was defined as neonates either born with LBW (<2.5 Kg) or prematurely (<37 weeks); and group 2 included term and BW ≥2.5Kg neonates. Perioperative data and long-term outcomes including parameters of renal function were compared between the 2 groups. Additionally, we analyzed objective kidney ultrasonographic parameters to correlate with the renal function prognosis: total parenchymal kidney area (TPA) and the renal echogenicity index (EI) of each kidney.
Results: Forty-four neonates were identified with Group 1 comprised of 25 preemies/LBW neonates while group 2 included 19 term neonates/NBW. No statistically significant differences were encountered between the groups regarding age at surgery (both with a median of 7 days-of-life; p=0.91) or time of follow-up in months (mean of 91 39 for group 1 vs 74 39.5 for group 2, p=0.16). Significant differences however, were encountered in renal function parameters between groups 1 and group 2, measured by eGFR (78 [39.3 - 133] vs 116.8 [84 - 158.5] mL/min per 1.73m2; p=0.02). Additionally, objective ultrasonographic parameters including total renal parenchymal area (TPA) and kidney echogenicity index (KEI) measured with imageJ software showed smaller and
more echogenic kidneys in the preemie/LBW group. These parameters also demonstrated their usefulness to predict ESRD during follow-up (image). No other differences were found with respect to the other variables analyzed including valve revision rates, urethral strictures, voiding dysfunction or intermittent catheterization.
Conclusion: primary ablation of posterior urethral valves is a feasible approach during the neonatal period. Although no differences in complications between term/NBW and preemieLBW/ neonates were observed, this latter population had decreased kidney reserve and consequently higher rates of CKD.


Back to 2019 Abstracts