A Systematic Review on Renal and Bladder Dysfunction after Endoscopic Treatment of Infravesical Obstruction in Boys 英文参考文献.docVIP

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A Systematic Review on Renal and Bladder Dysfunction after Endoscopic Treatment of Infravesical Obstruction in Boys 英文参考文献.doc

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A Systematic Review on Renal and Bladder Dysfunction after Endoscopic Treatment of Infravesical Obstruction in Boys 英文参考文献

ASystematicReviewonRenalandBladderDysfunction afterEndoscopicTreatmentofInfravesicalObstructionin Boys PaulineM.L.Hennus1*,GeertJ.M.G.vanderHeijden2,J.L.H.RuudBosch1,TomP.V.M.deJong1,3, LaetitiaM.O.deKort1 1Department ofUrology, University MedicalCenter Utrecht, Utrecht, The Netherlands, 2Department ofEpidemiology,Division Julius Center for Health Sciences and PrimaryCare,andDepartmentOtorhinolaryngology,DivisionSurgicalSpecialties,UniversityMedicalCenterUtrecht,Utrecht,TheNetherlands,3PediatricRenalCenter Wilhelmina Children’s Hospital and University Medical Center Utrecht and Elisabeth Children’s Hospital and Academic Medical Center Amsterdam, Amsterdam, The Netherlands Abstract Background: Posterior urethral valves (PUV) may cause subtle to severe obstruction of the urethra, resulting in a broad clinical spectrum. PUV are the most common cause of chronic renal disease in boys. Our purpose was to report the incidencesofkidneyandbladderdysfunctioninboystreatedwithendoscopicvalveresectionforPUV. Methodology: We searched MEDLINE and EMBASE databases until 1st of July 2011, to identify original papers that describedoutcomeofendoscopicvalveresection(EVR)inboys.Weextractedinformationon(1)patientcharacteristicsand clinical presentation of PUV related to outcomes and (2) the post-treatment absolute risks for kidney and bladder dysfunction. Principalfindings:Thirty-fourstudiesdescribingrenalfunction,vesicoureteralreflux(VUR),incontinence,andurodynamic bladder function after EVR in 1474 patients were retrieved. Patients treated for PUV show high percentages of chronic kidneydisease(CKD)orendstagerenaldisease(ESRD),22%(0–32%)and11%(0–20%),respectively.Elevatednadirserum creatininewastheonlyindependentfactorassociatedwithrenalfailure.Beforetreatment,VURwaspresentin43%ofboys and after EVR, VUR was present in 22%. Post treatment, 19% (0–70%) was reported to suffer from urinary incontinence. Urodynamicbladderdysfunctionwasseeninmanypatients(55%,0–72%)aftertreatmentofPUV. Concl