Role of Alpha Adrenergic Blocker on Bladder Emptying In Children with Posterior Urethral Valves after Valve Ablation
Journal Title: Scholars Academic Journal of Biosciences - Year 2017, Vol 5, Issue 10
Abstract
Role of alpha adrenergic blocker in children with posterior urethral valves after valve ablation.Seventy one children with significant post void residual urine from January 2009 to December 2012, after confirming there was no residual valve on repeat VCUG, were taken for the study. Children less than 2 years of age and children more than 2 years of age, with significant post void residual urine were placed on 0.1 mg and 0.2 mg capsule Tamsulosin respectively. Post void residual urine (PVR) and uroflowmetry was done at the commencement of alpha blocker and at follow up. PVR was monitored with abdominal ultrasound by two different observers. We also look for breakthrough urinary tract infection in children during the study.Post void residual urine significantly reduced in 71 patients. Mean pretreatment PVR was 31.59+/- 1.30ml and mean PVR, at the last follow up was 7.62+/- 4.36 ml. (P =0.000) There was a reduction of 75.87% in the pretreatment post void residual urine volume.Mean pretreatment Qmax was 10.77+/-6.57 ml/min and it was 13.78+/-8.58 ml/min at the last follow up in toilet trained children. (P =0.000) 34 patients had history of recurrent urinary tract infection. At last follow up, there was resolution of breakthrough urinary tract infection. These children had reflux on micturating cystourethrogram. This may be due to decrease in PVR. Mean follow up was 36+/- 10.5 months.Alpha 1 adrenergic blocker therapy in children with posterior urethral valves results in significant improvement in bladder emptying. It reduces episodes of breakthrough urinary tract infection. Further research in form of randomized controlled trials and long-term follow up are necessary to further define the role of an adrenergic blocker therapy in children with posterior urethral valves.
Authors and Affiliations
Singh SK, Sharma V, Srivastava A
Keywords
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