Clinical application of ureteroscope holmium laser in the treatment for urethral valve disease of neonates

Objective To evaluate the clinical efficacy of ureteroscope holmium laser in the treatment of urethral valve disease of neonates. Methods Retrospective analysis was performed for the clinical data of 23 hospitalized cases of PUV from January 2015 to January 2017. All of them were boys with an average age of 13.3(3-26) days. Prior to surgery, all of them were examined by ultrasound, voiding cystourethrograph (VCUG) and intravenous urography (IVU). All patients received transurethral ureteroscopic holmium laser PUV excision. Postoperatively balloon catheter was implanted for 2 weeks. Results Postoperative examination of VCUG showed that distal urethral stenosis disappeared (n=21) and persisted (n=2). After a second excision, urethral image was decent. During a follow-up period of 8-32 month, there was no cicatricial stenosis. Eight cases of ureteral reflux disappeared within 1 year and hydronephrosis relieved or disappeared; reflux and hydronephrosis relieved (n=6); postoperative hydronephrosis stabilized (n=5) and worsening hydronephrosis (n=4). At 6 months post-operation, VCUG reexamination showed that morphology of bladder and diverticulum of bladder improved in all cases. Serum creatinine normalized and there was no case of renal failure. Conclusions Both effective and feasible in the treatment of urethral valve disease, transurethral ureteroscope with holmium laser is particularly suitable for neonates. Many children with posterior urethral valve diseases have long-term renal impairment and bladder dysfunction so that long-term follow-ups are vital. Key words: Infant, newborn; Posterior urethral valve; Holmium laser; Ureteroscope