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Master Thesis

L'effet pop-off est-il vraiment protecteur dans les valves de l'urètre postérieur ? analyse combinée de la fonction rénale et vésicale

Abstract : Introduction: the posterior urethral valves (PUV) have both an impact on bladder function and renal function. Retrospective studies have identified prognostic factors for this pathology, some of which evoke the pop-off mechanism. However, it is not clearly defined, and its joint action on the kidneys and bladder is not established. The purpose of this study is to identify this mode of action and to assess its protective nature. Method: we report a multicenter retrospective study of boys with PUV, diagnosed between 1 January 2000 and 31 July 2013, among whom some had another nephrourological abnormality, defining the pop-off effect (VURD syndrom - urinoma - large bladder diverticula). Nadir creatinine (NC) in the first year after valve ablation was used to assess renal function. Uroflow was chosen to characterize bladder function. Results: pop-off factors were present in 22 boys (30.1%) of the 73 children included. None of these boys had an NC greater than 75 μmol / L and the rate of chronic renal failure (CKD) in their last was 40.9% against 55.6% in those without factor pop-off. Uroflow was normal for 63.6% of children with pop-off factors versus 47.1% of children without, without significant difference. On the other hand, the rate of CKD was greater and uroflow was abnormal when the NC was high (respectively p <0.0001 and p = 0.01). Conclusion: the pop-off mechanism in boys with PUV exists, and it appears protective in severe forms of PUV although our results are not statistically significant. NC confirms its role as a predictive factor of renal function in the long term; it also makes it possible to anticipate the subsequent bladder function.
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https://dumas.ccsd.cnrs.fr/dumas-02456446
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Thomas Delefortrie. L'effet pop-off est-il vraiment protecteur dans les valves de l'urètre postérieur ? analyse combinée de la fonction rénale et vésicale. Sciences du Vivant [q-bio]. 2018. ⟨dumas-02456446⟩

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