Related Experiment Video
Updated: Jun 21, 2026
Vessel-sparing Excision and Primary Anastomosis
Published on: January 7, 2019
Long-term upper and lower urinary tract functions in children with posterior urethral valves
Hasan Otukesh1, Farzaneh Sharifiaghdas, Rozita Hoseini
1Urology and Nephrology Research Center, Shaheed Beheshti University of Medical Science, Labbafi Nejad Hospital, Ali Asghar Children's Hospital, Tehran, Iran. hasanotukesh@yahoo.com
Insights
Posterior urethral valves (PUV) can lead to long-term renal and lower urinary tract issues. Early management factors like incontinence and reflux predict future renal failure in children with PUV.
Area of Science:
- Pediatric Urology
- Nephrology
- Pediatric Surgery
Background:
- Posterior urethral valves (PUV) are a common congenital anomaly in male infants.
- Predictive factors for long-term renal function in children with PUV require further analysis.
Purpose of the Study:
- To analyze upper and lower urinary tract outcomes in patients with PUV.
- To identify early management factors predicting future renal function in children with PUV.
Main Methods:
- Retrospective chart review of 67 boys diagnosed with PUV.
- Analysis of presenting symptoms, renal survival, and risk factors for renal failure and lower urinary tract dysfunction.
Main Results:
- 34.8% of patients developed end-stage renal disease.
- Incontinence, lower urinary tract dysfunction, early serum creatinine, and vesicoureteral reflux were significant risk factors for renal failure.
- Postnatal diagnosis and high-grade reflux predicted lower urinary tract dysfunction.
Conclusions:
- PUV have lasting consequences beyond childhood and treatment.
- Long-term monitoring of upper and lower urinary tract function after valve ablation is crucial.
Objective:
Several factors have been identified as predictive of future renal function in children with posterior urethral valves (PUV). Our aim was to analyse upper and lower urinary tract outcome in patients with PUV, and determine any factors from the period of early management that were predictive of future renal function.
Methods:
The charts of 67 boys (mean age 2.4 years) diagnosed with PUV were reviewed. The most common presenting symptom was dribbling in 43.2% and UTI in 28.3%. Twenty-three (34.8%) patients developed end-stage renal disease aged 1-15 years. The mean time of renal survival was calculated as 7.8 (SEM=0.73) years.
Results:
Incontinence in patients over 5 years old, lower urinary tract dysfunction, serum creatinine level in first year or at the time of diagnosis, and presence of vesicoureteral reflux and high-grade bilateral reflux were significant risk factors for occurrence of renal failure in the future. Lower tract dysfunction was seen in 58.6% of patients. Postnatal diagnosis and presence of high-grade reflux were significant risk factors for the future occurrence of lower urinary tract dysfunction.
Conclusion:
It is important to recognize that PUV have consequences not only during childhood or before treatment, but also during or after the treatment period. Long-term assessment and follow-up of upper and lower urinary tract functions after valve ablation is necessary.
Related Concept Videos
01:19Anatomy of the Genitourinary System II: Bladder and Urethra
01:30Urinary Tract Calculi III: Medical Management
01:25Urinary Tract Calculi VI: Surgical Management
01:26The Micturition Reflex
The process begins with bladder filling, where the bladder wall stretches as urine accumulates. This stretching activates the urine storage reflex, mediated by the sacral spinal segments and the pontine storage center. Efferent sympathetic impulses stimulate the detrusor muscle to relax and the internal urethral sphincter to contract, facilitating urine...
01:19Urodynamic Studies: Uroflowmetry
01:26Urinary Tract Calculi II: Pathophysiology and Clinical Manifestations