TOPLINE

In boys with continued kidney swelling and bladder issues after valve ablation, overnight bladder drainage for 12 months improved kidney swelling and urine reflux, without worsening function or increasing the number of febrile urinary tract infections.

METHODOLOGY

• Researchers conducted a randomized controlled trial (2021-2023) to assess whether overnight bladder drainage improved urinary tract outcomes in boys with persistent hydronephrosis and abnormal bladder dynamics after endoscopic valve ablation.
• The analysis included 99 boys at a tertiary center in Egypt who were randomly assigned to undergo overnight bladder drainage (n = 47; median age, 5.3 years) or standard care (n = 52; median age, 4.5 years).
• Caregivers of boys in the drainage group placed a catheter in the boys’ bladders connected to collection bags each night for 8-12 hours for 1 year.
• Both groups followed a timed voiding schedule, took oxybutynin, and received daily antibiotic prophylaxis.
• The primary outcome was improvement in hydronephrosis assessed using renal ultrasonography, along with improvements in urine backflow, bladder shape and function, kidney function and scarring, and occurrence of febrile urinary tract infections.

TAKEAWAY

• Hydronephrosis improved in 72% of boys in the drainage group vs 25% in the standard care group (odds ratio [OR], 7.85; P < .001).
• Backflow of urine to the kidneys was more likely to improve in the drainage group than in the standard care group (OR, 3.79; P = .026). Renal parenchymal area was larger in the drainage group (P < .001).
• Boys in the overnight drainage group had better bladder capacity, smoother bladder outline, fewer overactivity episodes, and better compliance (P < .05 for all).
• Overnight bladder drainage did not affect bladder wall thickness, post-void residual urine volume, bladder sensation, kidney function or scarring, or the occurrence of febrile UTI.

IN PRACTICE

“[The] findings endorse overnight bladder drainage as an effective tool to manage persistent sequelae following endoscopic valve ablation,” the researchers wrote.

SOURCE

The study was led by Ahmed Elkashef of Mansoura University in Egypt. It was published online on July 21 in The Journal of Urology.

LIMITATIONS

Excluding patients who do not tolerate overnight bladder drainage may have introduced attrition bias. Researchers could not conclude whether the benefits of bladder drainage lasted after treatment. 

DISCLOSURES

The authors did not disclose any funding or conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.