Renal Efficacy of Mitrofanoff Drainange in Boys with PUV
Purpose Boys with posterior urethral valves (PUV) progress to end stage renal failure (ESRF) in 1/4 cases. It has been hypothesized that Mitrofanoff formation and intermittent catheterization with overnight drainage protects renal function. This benefit has not been quantified. Mitrofanoff formation has been performed at our centre for many years. Boys with PUV who had Mitrofanoff formation were identified and renal status pre and post-op compared, as was age at onset of ESRF in the Mitrofanoff group compared to historical controls. Material and Methods A retrospective analysis of boys with PUV and Mitrofanoff formation was performed, and a database of (ESRF) patients searched. Firstly, comparison of pre and post Mitrofanoff renal function and hydronephrosis was made. Secondly the age (years) at which PUV boys progressed to ESRF with and without Mitrofanoff drainage was compared. Results given as mean±SEM. Statistical analysis was by paired or 2-sample students t-test as appropriate, p Results Mitrofanoff formation was performed in 25 PUV boys. Data for 19 patients pre-op and post-op creatinine (118±18 μmol/l vs. 125±22 μmol/l), was not significantly different, p=0.13. Hydronephrosis was significantly reduced in 26 renal units, pre-op 1.9±0.1 cm vs. post-op 1.1±0.1 cm, p Conclusions Short-term Mitrofanoff drainage of bladders in PUV boys reduces renal dilatation by 40%, but doesn't change renal function. Long-term Mitrofanoff drainage significantly delays the onset of ESRF in PUV boys by 5 years.