Presentation of Posterior Urethral Valves in Saudi Arabia in the 90's

To evaluate the age and mode of presentation of patients with posterior urethral valves (PVU) in the antenatal and postnatal periods, we analyzed the files of 108 patients with the diagnosis of PUV in four referral hospitals in Riyadh, Saudi Arabia from 1989 to 1999. Of the study patients, 29 (27%) were antenatally discovered, 41 (38%) in the first year of life and 38 (35%) after the first year of life. The mode of presentation was by antenatal ultrasound in 29 (27%) patients, urinary tract infection in 33 (30.4%) patients, poor urinary stream in 35 (32.4%) patients, retention of urine in neonatal life in eight (7.4%) patients and symptoms of renal impairment in three (2.8%) patients. We conclude that the antenatal detection rate of PUV in our study patients is less than the international one (70%), despite the fact that most of the antenatal follow-ups were done in centers where ultrasound was available for routine antenatal work up. This calls for more vigilance by the radiologists and obstetricians to enhance the rate of detection of PUV.