Efficacy and Tolerability of Overnight Bladder Drainage Post Posterior Urethral Valve Ablation on Upper and Lower Urinary Tracts: A Randomized Controlled Trial.

In 30 seconds

This randomized controlled trial assessed overnight bladder drainage (OBD) in boys with persistent hydronephrosis and unfavorable bladder dynamics after endoscopic posterior urethral valve ablation. Ninety-nine patients were allocated to OBD (47) or no OBD (52), with outcomes assessed after 12 months. OBD was associated with significant improvement in hydronephrosis, vesicoureteral reflux, renal parenchymal area, several measures of bladder morphology and function, daytime continence, and nocturnal polyuria. No significant between-group differences were found in renal function, renal scarring, or febrile urinary tract infections. OBD was tolerated by 87% of patients.

Key findings

• At 12 months, OBD significantly improved hydronephrosis, vesicoureteral reflux, and renal parenchymal area compared with no OBD.
• Bladder capacity, outline, detrusor overactivity, and compliance improved significantly with OBD.
• Daytime continence and nocturnal polyuria improved significantly with OBD; tolerability was reported in 87% of patients.
• No significant group differences were found in renal function, renal scarring, or febrile urinary tract infections.

Why it matters

Persistent upper- and lower-tract abnormalities can remain after valve ablation. This trial suggests that overnight drainage may improve several urinary tract measures and continence-related outcomes in affected boys, while no between-group difference was detected in renal function or febrile infections over the study period. The findings help characterize a potential adjunctive approach, alongside the other care offered to both groups.

What to keep in mind

Follow-up was 12 months, and the study included boys with persistent hydronephrosis and unfavorable bladder dynamics after ablation; findings may not apply to other populations or longer-term outcomes.