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Abstract

RÉSUMÉ
Introduction. Les valves de l’urètre postérieur (VUP) sont la principale cause d’obstruction congénitale du bas appareil urinaire chez le garçon. En Afrique subsaharienne, leur diagnostic souvent tardif compromet le pronostic rénal. La vésicostomie constitue une option de dérivation urinaire lorsque l’ablation endoscopique est impossible. Cette étude évaluait son efficacité et sa morbidité chez l’enfant au CHU de Treichville. Méthodes. Il s’agissait d’une étude analytique rétrospective menée sur 10 ans (2014–2023) en chirurgie pédiatrique. Tous les enfants porteurs de VUP ayant bénéficié d’une vésicostomie selon la technique de Blocksom ont été inclus. Les données cliniques, radiologiques et biologiques ont été recueillies, notamment la créatininémie avant intervention et à 3 mois. Les complications postopératoires ont été analysées par le test exact de Fisher (p = 0,05). Résultats. Quarante-neuf patients ont été inclus, avec un âge médian de 30 jours (4 jours–6 ans). Les principaux motifs de consultation étaient les troubles urinaires (44,9 %), la distension abdominale (34,7 %) et l’infection urinaire (12,2 %). La vésicostomie était néonatale dans 39 % des cas. La créatininémie moyenne diminuait de 25,9 à 11,25 mg/L à 3 mois. Dix-sept complications (35 %) ont été recensées, principalement des infections urinaires (7 cas). Trois décès sont survenus, sans association significative avec les complications de la vésicostomie (p = 0,4). Conclusion. La vésicostomie améliore la fonction rénale et constitue une option de dérivation fiable avant le traitement définitif des VUP, notamment lorsque l’endoscopie néonatale n’est pas disponible. Une meilleure éducation parentale pourrait réduire la morbidité infectieuse.
ABSTRACT
Introduction. Posterior urethral valves (PUV) are the leading cause of congenital lower urinary tract obstruction in boys. In sub-Saharan Africa, delayed diagnosis often worsens renal outcomes. Vesicostomy provides urinary diversion when endoscopic valve ablation is not feasible. This study assessed its therapeutic value and morbidity in children at Treichville University Hospital. Methods. We conducted a 10-year retrospective analytical study (2014–2023) in the Pediatric Surgery Department. All children with PUV who underwent Blocksom vesicostomy were included. Clinical, imaging, and laboratory data were collected, including serum creatinine before surgery and at 3 months. Postoperative complications were analyzed using Fisher’s exact test (p = 0.05). Results. Forty-nine patients were included, with a median age of 30 days (range, 4 days–6 years). The main presenting features were urinary symptoms (44.9%), abdominal distension (34.7%), and urinary tract infection (12.2%). Vesicostomy was performed during the neonatal period in 39% of cases. Mean serum creatinine decreased from 25.9 to 11.25 mg/L at 3 months. Seventeen complications (35%) were recorded, mainly urinary tract infections (7 cases). Three deaths occurred, with no significant association between mortality and vesicostomy-related complications (p = 0.4). Conclusion. Vesicostomy improves renal function and remains a reliable urinary diversion procedure before definitive PUV treatment, particularly where neonatal endoscopic equipment is unavailable. Enhanced parental education on stoma care may help reduce infectious morbidity.

Keywords

Vesicostomy; Posterior urethral valves; Morbidity; Prognosis; Côte d'Ivoire Vésicostomie ; Valves de l'urètre postérieur ; Morbidité ; Pronostic ; Côte d'Ivoire

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This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

How to Cite
Konan KJM, Akproh ARC, Agbara KS, Ehua AM, Konan AJ, & Moulot MO. (2026). Vesicostomy for Posterior Urethral Valves in Abidjan: A Retrospective Analysis of Complications and Renal Function Preservation : La Vésicostomie dans les Valves de l’Urètre Postérieur à Abidjan (Côte d’Ivoire) : Analyse Rétrospective des Complications et de la Préservation de la Fonction Rénale . HEALTH SCIENCES AND DISEASE, 27(10), 169–173. https://doi.org/10.67260/hsd.v27i10.7915
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References

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