Hot vs cold knife for endoscopic ablation of posterior urethral valves: a systematic review by the EAU-YAU paediatric urology working group.
Yesica Quiroz Madarriaga, M İrfan Dönmez, Christa Gernhold et al.
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In 30 seconds
This systematic review evaluated the effectiveness of cold versus hot knife techniques for endoscopic ablation of posterior urethral valves (PUV) in children. Analyzing 26 studies with 1725 patients, it found that both techniques achieved high single-session success rates, with cold resection showing slightly lower complication rates. However, the heterogeneity of the studies limited direct comparisons.
Key findings
- Single-session success rates for cold ablation ranged from 22% to 100%, while hot ablation ranged from 71.4% to 100%.
- Reintervention rates for residual valves were reported at 0%-78% for cold and 0%-28.6% for hot techniques.
- Urethral stricture rates after cold techniques ranged from 0% to 11.1%, compared to 0% to 23.8% for hot techniques.
Why it matters
Understanding the comparative effectiveness and safety of cold versus hot knife techniques for PUV ablation is crucial for optimizing surgical outcomes and minimizing complications in pediatric patients.
What to keep in mind
The included studies exhibited marked heterogeneity in design, follow-up duration, and outcome reporting, which limited direct comparisons.