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Updated: Jun 24, 2026
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Published on: January 7, 2019
[Posterior urethral valves: prenatal diagnosis, neonatal data and outcome]
Insights
Prenatal diagnosis of posterior urethral valves (PUV) and pregnancy termination have improved outcomes. Most children born with PUV now have a better renal prognosis, with renal function at 1 year being the key predictor.
Area of Science:
- Pediatric Urology
- Prenatal Diagnosis
- Renal Development
Context:
- Posterior urethral valves (PUV) represent a significant congenital anomaly in male newborns.
- The advent of prenatal diagnosis allows for early identification of severe PUV cases.
- Medical termination of pregnancy is now an option for the most severe presentations.
Purpose:
- To assess the influence of prenatal diagnosis on the epidemiology and outcomes of children with PUV.
- To analyze the impact of pregnancy termination on the overall management and prognosis of PUV.
- To evaluate long-term renal function in children diagnosed with PUV prenatally.
Summary:
- A study of 43 PUV cases (1998-2007) in Languedoc-Roussillon detailed prenatal findings and postnatal outcomes over a 7.6-year follow-up.
- Fifteen severe cases underwent medical termination; one fetus experienced in-utero demise.
- Of 27 live births, one neonate died from lung hypoplasia. Among 26 survivors, 5 showed mild renal insufficiency, and one developed end-stage renal failure by age 7. Proteinuria and hypertension were infrequent.
Impact:
- Prenatal diagnosis and selective pregnancy termination have positively altered the epidemiology and prognosis of PUV.
- Children born with PUV now exhibit improved renal outcomes compared to historical data.
- Postnatal renal function at one year remains the most critical indicator for long-term renal prognosis in PUV patients.
Aim Of The Study:
To evaluate the impact of prenatal diagnosis on the epidemiology and outcome of children with posterior urethral valves (PUV), considering that today termination of pregnancy may be proposed in the most severe cases.
Patients And Methods:
Forty-three cases of patients with PUV were diagnosed between 1998 and 2007 in the Languedoc-Roussillon region. In this study, we detailed the prenatal data and postnatal outcome of those patients with a mean follow-up period of 7.6 years.
Results:
Medical interruption of pregnancy was performed in 15 severe cases. One death in utero was also observed. Twenty-seven patients were managed postnatally and one child died during the neonatal period because of lung hypoplasia. For the 26 remaining patients at the end of the follow-up period, 5 had mild renal insufficiency with a creatinine clearance calculated with the Schwartz formula of less than 80 ml/min/1.73 m2. One reached end-stage renal failure at the age of 7 years. Proteinuria and hypertension were rare.
Discussion And Conclusion:
Today, because of the increase in medical termination of pregnancy in the most severe cases, most of the children born alive with PUV experienced a better renal prognosis when compared with previous data. Prenatal diagnosis and therapeutic progress significantly modified the epidemiology and outcome of this disease. Nevertheless, the best predictor of renal outcome remains renal function at 1 year of age.
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