Posterior urethral valves: a single center experience over 7 years

Area of Science:

• Pediatric Urology
• Surgical Outcomes
• Congenital Anomalies

Background:

• Posterior urethral valves (PUV) are a common cause of bladder outlet obstruction in male infants.
• Management aims to prevent upper urinary tract damage and preserve renal function.
• Surgical ablation of valves is the primary treatment modality.

Purpose of the Study:

• To compare the outcomes of two valve ablation techniques in children with PUV.
• To evaluate the efficacy of Mohan's urethral valvotome versus electrocautery fulguration.
• To assess complication rates and long-term renal function.

Main Methods:

• Retrospective review of 65 children with PUV over 7 years.
• Two groups: primary ablation with Mohan's valvotome, secondary ablation with electrocautery.
• Monitoring of serum electrolytes, post-void residue (PVR), and alpha-blocker use.

Main Results:

• 58 patients underwent primary ablation (37 valvotome, 21 fulguration).
• Mohan's valvotome group had 0 strictures; fulguration group had 5 strictures (P<0.05).
• No significant difference in residual valves or PVR between groups; improved renal function observed.

Conclusions:

• Early PUV ablation and attentive bladder management improve outcomes.
• Mohan's valvotome is associated with a lower incidence of urethral strictures compared to electrocautery.
• Both methods achieve comparable results for residual valves and PVR post-ablation.