Muhammad Zulfiqar Anjum, Muhammad Zubair, Abid Hamid Sheikh.
Role of Temporary End Uretrostomies in Advance Cases of Posterior Urethral Valve Obstruction Presenting with Chronic Renal Failure.
Ann Pak Inst Med Sci Jan ;11(2):78-80.

Objective: Our study aims at determining the effectiveness of surgical protocol in the management of advanced cases of posterior urethral valve in improving the GFR. Study Design & Setting: This is interventional study conducted at the Pediatric Surgery Department, B.V Hospital Bahawalpur from May 2008 to May 2011. Materials & Methods: In a total of 46 cases of congenital obstructive uropathy fulfilling the inclusion and exclusion criteria temporary end uretrostomies were performed. Urine complete examination, S.creatinine level and ultrasonography were done every 3 months and radionucleoid renal scan, every 6 months after the primary surgery up to average 18 months. After the follow up of 18 months ureter re-implantation was performed. In cases of posterior urethral valves, the valve ablation was done at the time of ureter reimplantation. Results: Out of total 46 cases 27(58.6%) were less 2 year of age and 19(41.4%) were above 2 year age with mean age ±SD was 4.95±3.37 year. 43(93%) were male and 3(7%) were female. GFR of all the patients was recorded that was 21.35 ml ±6.21 (mean ±SD) from prior to ureterostomies and at the end of study after 18 months GFR was 65.35 ±11.77m. Five cases shoed no improvement in GFR so referred to nephrologist/transplant surgeon. Four cases (8.7%) were lost during follow up and 37(80.43%) children underwent definitive surgery Conclusion:Temporary end uretrostomies in cases of primary congenital obstructive uropathy with Grade IV or V vesicoureteric reflux is effective procedure in temporizing higy grade vesico ureteric reflux and the children who developed chronic renal failure.

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