Posterior urethral valves: the scenario in a developing center.

Area of Science:

• Pediatric Urology
• Surgical Outcomes
• Renal Health

Background:

• Posterior urethral valves (PUV) are a common congenital anomaly in male infants, leading to bladder outlet obstruction.
• Long-term outcomes and management strategies for PUV require continuous evaluation.

Purpose of the Study:

• To review the clinical presentation, diagnosis, and treatment outcomes of 233 patients with posterior urethral valves.
• To assess the efficacy of primary endoscopic valve ablation versus diversion procedures.
• To identify challenges in long-term follow-up and propose improvements.

Main Methods:

• Retrospective review of 233 patients diagnosed with posterior urethral valves over a 20-year period.
• Analysis of clinical presentation, diagnostic methods, and surgical interventions (primary valve ablation, diversion).
• Evaluation of short- and long-term patient outcomes, including mortality, renal function, and overall health status.

Main Results:

• Primary endoscopic valve ablation was performed in 60% of patients, while diversion was used in 43%.
• Of the 233 patients, 11 died during initial hospitalization, and 15 developed end-stage renal disease.
• 169 patients remain in good health after 1-20 years of follow-up, but concerns exist regarding high diversion rates and follow-up adherence.

Conclusions:

• Primary valve ablation can yield excellent results in carefully selected patients with posterior urethral valves.
• The study highlights a need to reduce the rate of urinary diversion and improve long-term patient follow-up strategies.
• Ongoing efforts focus on refining management to mitigate these identified challenges.