BACKGROUND: We aimed to evaluate the effect of overnight bladder drainage using catheter (OBD) on the upper urinary tracts and bladders of boys post posterior urethral valve (PUV) ablation.
METHODS: In a randomized controlled trial, boys who had persistent hydronephrosis (HN) at least one year after PUV ablation were included. Those who underwent urinary diversion, had infravesical obstruction or refused to participate were excluded. Patients were randomly allocated into OBD (catheter placement in bladder for 8-12 h every night) or no OBD groups. Timed voiding every 3 h, anticholinergics and antibiotic prophylaxis were offered for both groups. After 12 months of starting treatment, patients were evaluated for compliance to OBD, daytime continence (>3 h dry), febrile urinary tract infections (UTIs), renal function evaluation by serum creatinine (SCr) and dimercaptosuccinic acid (DMSA) scan, improvement in HN, vesicoureteral reflux (VUR) and bladder morphology assessed by renal & bladder ultrasound and voiding cystourethrogram.
RESULTS: A total of 106 patients; 54 patients underwent OBD and 52 patients had no OBD, were included between August 2021 and September 2022 and completed 12 months of follow up. Compliance to OBD was reported in 47 patients, those who were included in the analysis. OBD group showed significant improvement in HN and VUR (Table 1), bladder capacity and outline (Table 2). Daytime dryness was also more significantly noted in OBD patients (63.8% vs. 44.2%, p=0.04). However, no significant difference was found between both groups regarding febrile UTIs, renal function affection estimated by SCr and DMSA scan, bladder wall thickness or post-void urine residual.
CONCLUSIONS: OBD might improve persistent HN, VUR, abnormal bladder morphology and daytime continence after PUV ablation with no subsequent increase in febrile UTIs or renal function affection. Yet, compliance to OBD remains a matter of concern.
