Introduction:

Posterior urethral valves (PUV) is a chronic condition that can adversely impact quality of life (QOL). Surprisingly, to date, the impact of this condition on the QOL of children with PUV has not been studied. Thus, our aim is to evaluate this important aspect of care using validated questionnaires in our institutional PUV clinic.

Methods

From December 2022 to May 2023, we distributed the PedsQL Inventory, which is a validated tool for assessment of health-related QoL in children and adolescents. It provides a measure of the impact of chronic illness on physical and psychosocial QoL with maximum score of 100 in each domain, and higher scores reflecting better QoL. Children >8 years old completed the tool themselves, otherwise parents completed the tools on behalf of the child. We compared PUV scores against reported psychometric data from healthy children and other chronic illnesses. We performed subgroup analyses stratified by age, initial surgical intervention (ablation/diversion), need for catheterizations, and progression to renal replacement therapy.

Results

A total of 60 patients ages 7+/-5 years completed the instrument. The total QoL score was 83+/-12, physical score was 90+/-12 and psychosocial was 79+/-16. We found no significant differences in QoL (total, psychosocial, physical) when we compared those on CIC, those managed with a diversion, transplant or by age (Table 1). However, when comparing physical to psychosocial, psychosocial scores were significant lower in each domain assessed (Table 2). When PUV patients were compared to healthy children, there was no difference in total QoL scores (83+/-12 vs. 82 +/- 16; p=0.63), but when compared to other children with chronic illness, PUV patients had significantly higher QoL scores (83+/-12 vs. 73 +/- 16; p<0.01).

Conclusion

It appears that QoL is not significantly impacted in children with PUV, however, there is a clear discrepancy between physical and psychosocial domains, suggesting that PUV patients experience more psychosocial/mental health issues than physical impairment. These results are valuable to guide family counselling and highlight the need to advocate for mental health/psychological support for children impacted by PUV.