A retrospective review was undertaken of 5 pediatric cases of posterior urethral valve with vesicoureteral reflux. The clinical data were summarized as follows : 1. At the time of diagnosis, patient age was recorded as 2 months, 3, 4, 13, and 14 years. Three cases presented with high fever, one with urinary dribbling and one with acute epididymitis. 2. Voiding cystourethrogram was abnormal in all cases, showing thickened, trabeculated bladder wall, dilatation of posterior urethra and vesicoureteral reflux. Vesicoureteral reflux was bilateral in 3 cases, unilateral in 2 cases and its degree was grade R-V/V in 8 renal units, grade E/V in one renal unit. 3. Initially transurethral valve ablation was performed in all cases, of which 2 had concomitant antireflux surgery and 3 had delayed ureteral reconstruction between one and 11 months after valve ablation. 4. Follow up duration was between 13 and 53months. In 4 cases, reflux disappeared and the pyelographic appearance markedly improved as regards pelvocalyceal and ureteral dilatation with improvement of general status at followup. But, in one case that had demonstrated bilateral high grade vesicoureteral reflux with sever ureteral dilatation and poor renal function, voiding symptom and radiologic appearance improved but left vesicoureteral reflux persisted by 13 months after reconstructive surgery.
Diagnosis ; Dilatation ; Epididymitis ; Fever ; Follow-Up Studies ; Humans ; Male ; Retrospective Studies ; Ureter ; Urethra ; Urinary Bladder ; Vesico-Ureteral Reflux*

Purpose: This study aimed to analyze the overall survival (OS) in patients with metastatic castration-resistant prostate cancer (mCRPC) treated with either combination or only secondary hormone therapy (2ndHTx) or docetaxel chemotherapy. Materials and Methods: Between 2005 and 2018, 307 mCRPC patients’ medical records were retrospectively reviewed treated with either 2ndHTx (HTx [N=73, 23.8%] either abiraterone acetate or enzalutamide), docetaxel+2ndHTx (CTx-HTx [N=90, 29.3%]) or only docetaxel therapy (CTx-only [N=144, 46.9%]). The Cox proportional hazard model for risk factors of OS and Kaplan-Meier analysis with log-rank test for OS comparison among three therapeutic groups with a statistical significance of p＜0.05. Results: During a median 49.6-month follow-up and a median 22 months of OS, the worst OS was observed in CTx-only (17.7 months) followed by the CTx-HTx (22.9 months), and only-HTx (42.6 months) groups (p＜0.001). The baseline comparison showed that age, body mass index, TN stagings, and prostate specific antigen level were significantly different between groups (p＜0.05). In the multivariable analysis for the risk factors of OS, age (hazard ratio [HR], 0.978), cT3–4 stage (HR, 1.606), and HTx (HR, 0.482) were significant factors. With the HTx agents, enzalutamide was the only left risk factor for OS regardless of underlying diseases (HR, 0.511; p＜0.001). The group analyses for the OS showed that only-CTx group (HR, 2.696) and CTx-HTx group (HR, 1.434) were unfavorable factors for OS with a reference of HTx group (p＜0.001). Conclusions 2ndHTx was a significant prognostic factor for OS regardless of underlying diseases in patients with mCRPC and improved OS in comparison with docetaxel.