Related Experiment Videos
[Posterior urethral valves in Senegalese children. Fourteen cases]
Insights
Posterior urethral valves in children can cause urinary issues and, if untreated, lead to severe complications like renal failure. Early diagnosis and endoscopic resection are crucial for successful management and improved outcomes.
Area of Science:
- Pediatric Urology
- Medical Diagnostics
- Surgical Interventions
Background:
- Posterior urethral valves (PUV) are a congenital anomaly affecting the male urethra.
- Early identification and management are critical to prevent long-term sequelae.
Observation:
- This study reports on 14 pediatric cases of posterior urethral valves, with symptom onset often within the first year of life.
- Common symptoms included dysuria, acute urinary retention, and dribbling; one case presented with gastrointestinal symptoms.
- Associated conditions included bladder hyperplasia, diverticula, and urinary lithiasis.
Findings:
- Urethrocystography and intravenous urography were key diagnostic tools, revealing bladder repercussions and bilateral ureterohydronephrosis in most cases.
- Common urinary pathogens identified were Klebsiella, Pseudomonas, Proteus, and E. coli.
- While most patients treated with catheterization and antibiotics showed satisfactory results, two succumbed to renal failure.
Implications:
- Early diagnosis of posterior urethral valves is essential for timely intervention.
- Endoscopic resection is the preferred management strategy, offering reduced hospital stays and lower infection risks.
- Prompt treatment can significantly improve patient outcomes and prevent irreversible renal damage.
Abstract:
Fourteen pediatric cases of posterior urethral valves in patients aged 6 months to 14 years (with four infants and ten older children) are reported. The main symptoms were vesical, including dysuria, acute urinary retention and dribbling. One patient presented with diarrhea, vomiting and dribbling. Urethral valves were looked for as part of the evaluation for urinary lithiasis in one patient, and in another urinary lithiasis developed following the diagnosis of urethral valves. In half the cases, onset of symptoms occurred within one year of birth. Urethrocystography allowed to evidence the valves and to evaluate repercussions on the bladder including hyperplasia (7 cases) and diverticula (2 cases). The intravenous urogram disclosed bilateral ureterohydronephrosis in eight cases. Pathogens recovered from the urine included Klebsiella (3 patients), Pseudomonas (4 patients), Proteus (one patient), and E. coli (one patient). Most patients were treated by catheter lamination under antimicrobial therapy. Two patients died from renal failure. Results were considered satisfactory in nine cases with follow-ups ranging from 1 month to 4 years. Three patients were lost to follow-up. Early diagnosis is essential and management should rely mainly on endoscopic resection which reduces the length of the hospital stay and the risk of infection.