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Posterior urethral valves are the most common cause of bladder outlet obstruction in male newborns. Initial catheter drainage alleviates the urethral obstruction before definitive management by valve ablation. Newborns with posterior urethral valves often present with hypercontractile bladders that may inhibit upper tract drainage despite bladder catheterization. Anticholinergic agents are commonly used to treat detrusor hyperactivity, with oxybutynin being the most commonly used. We report the first case of a newborn with posterior urethral valves and ureterovesical junction obstruction caused by detrusor hypertrophy who underwent urgent intravesical instillation of oxybutynin at high doses in an attempt to avoid a diversion procedure.

Introduction Oesophageal pH-monitoring allows the quantification of gastric reflux episodes in patients with gastroesophageal reflux disease (GERD). The accuracy of the test depends on correct positioning of the pH sensor 5 cm above the lower oesophageal sphincter (LES). The most precise manner to locate the LES is through prior determination by oesophageal manometry. However, because this technique is uncomfortable, mathematical formulas tend to be used in children. Objectives To evaluate the applicability of paediatric formulas to estimate oesophageal length in adults and their effect on diagnostic accuracy. Material and methods A prospective study was carried out in adult patients, in whom the distance between the nasal orifice and the LES was determined by manometry and was compared with the estimated height-related distance calculated by four paediatric formulas (numbered 1–4). We also evaluated the relationship between the position of the probe and the percentage of reflux detected in our series of impedance measurements. Results Formula 1 (9.31 + height in cm × 0.197) was the most accurate (comparison of means −0.38 with 95% CI −0.70/−0.06, p = 0.019). With this formula, none of the patients had estimation errors of ±6 cm. With formulas 2, 3 and 4, the percentage of error was 4.4%, 1.5% and 32.0%, respectively. Conclusion Oesophageal length estimation in adults by using formula 1 is acceptable and can be used in adult patients who refuse to undergo prior manometry.

Resumen Introduccion La pHmetria esofagica permite cuantificar los episodios de reflujo acido en pacientes con enfermedad por reflujo gastroesofagico (ERGE). El posicionamiento adecuado del electrodo de pH a 5 cm por encima del esfinter esofagico inferior (EEI), determina la precision de la prueba. La manera mas exacta para localizar el EEI es mediante su determinacion previa por manometria esofagica, pero es una tecnica molesta, por lo que en ninos tendemos a utilizar formulas matematicas. Objetivos Valorar la aplicabilidad de las formulas pediatricas de estimacion de longitud esofagica en pacientes adultos y su repercusion en la precision diagnostica. Material y metodos Estudio prospectivo en pacientes adultos en el que la distancia desde el borde de la narina hasta el EEI determinada por manometria se ha comparado con la distancia estimada en relacion a la talla calculada por 4 formulas pediatricas (numeradas del 1 al 4). Tambien hemos valorado la relacion entre posicion de la sonda y porcentaje de reflujos detectados en nuestra serie de impedanciometria. Resultados La formula 1 (9,31 + talla cm × 0,197) fue la mas precisa (comparacion de medias −0,38 con IC 95% −0,70 a −0,06, p = 0,019). Con dicha formula, ningun paciente presento errores de estimacion de ± 6 cm. Con las formulas 2, 3 y 4 el porcentaje de error fue del 4,4, del 1,5 y del 32,0%, respectivamente. Conclusion La estimacion de la longitud del esofago en adultos mediante la formula 1 es aceptable y puede usarse en casos en los que el paciente rechace la realizacion de una manometria previa.