Abstract: TH-PO1195
Efficacy of Secondary Interventions for Bladder Dysfunction After Valve Ablation in Posterior Urethral Valves: A Systematic Review and Meta-Analysis
Session Information
- Pediatric Nephrology: CV Health, CKD, AKI, Dialysis, Transplantation, and Health Services Research
October 22, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Pediatric Nephrology
- 1800 Pediatric Nephrology
Authors
- Chattha, Sarmad Elahi, King Edward Medical University, Lahore, Punjab, Pakistan
- Ahmed, Hafsah Gulzar, King Edward Medical University, Lahore, Punjab, Pakistan
- Mandava, Snigdha, NRI Medical College Department of Community Medicine, Chinnakakani, AP, India
- Rashid, Amina Zia, Allama Iqbal Open University, Islamabad, Islamabad Capital Territory, Pakistan
- Jamshaid, Zainab, King Edward Medical University, Lahore, Punjab, Pakistan
- Tariq, Hanaa, Jinnah Sindh Medical University, Karachi, Sindh, Pakistan
- Ahmad, Fizza, King Edward Medical University, Lahore, Punjab, Pakistan
- Shabih, Sumaiya, King Edward Medical University, Lahore, Punjab, Pakistan
- Asnani, Sunny, Jinnah Post Graduate Medical Centre, Karachi, Sindh, Pakistan
- Ullah, Rahim, Gomal Medical College, Dera Ismail Khan, N.W.F.P, Pakistan
- Gulzar, Sara, King Edward Medical University, Lahore, Punjab, Pakistan
Background
Posterior Urethral Valves (PUV) represent the most common etiology of bladder outlet obstruction in male children. A significant proportion of patients develop persistent bladder dysfunction even after successful therapy with valve ablation (VA). Evidence regarding the clinical efficacy of proposed adjunctive management strategies remains conflicting.
Methods
We searched PubMed, Embase, Scopus, Cochrane Library and ClinicalTrials.gov from inception to May 2026 for studies reporting outcomes of adjunctive management of bladder dysfunction following VA. Pooled risk ratios (RRs) and mean differences (MDs) were calculated using a random-effects model. Heterogeneity was assessed using I^2 and Cochran's Q test. Sensitivity analysis was performed for selected variables.
Results
A total of 12 studies, comprising 924 patients, were included in the analysis. Compared to VA alone, secondary intervention did not significantly improve vesicoureteral reflux (VUR) resolution (RR 1.28, 95% CI 0.91-1.82; I^2=0%), serum creatinine (MD -0.20 mg/dL, 95% CI -0.53-0.13; p=0.24), detrusor overactivity (RR 0.64, 95% CI 0.22-1.86; p=0.41), maximum detrusor pressure at Qmax (Pdetmax) (MD -19.57 cmH2O, 95% CI -49.81-10.67; p=0.20), or re-intervention rates (RR 0.55, 95% CI 0.26-1.13; p=0.10). Peak flow rate was significantly higher in the intervention group (MD +3.15 mL/s, 95% CI 1.44-4.86; p=0.0003; I^2=0%). Bladder compliance showed a borderline improvement with intervention (MD +5.64 mL/cmH2O, 95% CI 0.08-11.20; p=0.05; I^2=96%).
Conclusion
Secondary interventions did not significantly improve urodynamic, renal or functional outcomes in PUV patients. The clinical significance of isolated improved peak flow rate remains uncertain. High heterogeneity and small sample sizes limit interpretation of results. Larger studies with standardized outcomes are needed to further guide evidence-based management.