Posterior urethral valves: long-term outcome.

Area of Science:

• Pediatric Urology
• Nephrology
• Adult Urology

Background:

• Posterior urethral valves (PUV) are the primary cause of bladder outlet obstruction in infants, significantly impacting renal and bladder function.
• Long-term outcomes for patients treated in infancy for PUV require thorough evaluation into adulthood.

Purpose of the Study:

• To assess the long-term renal, bladder, and sexual function in adult patients previously treated for posterior urethral valves in childhood.
• To identify the prevalence of chronic renal failure, hypertension, lower urinary tract symptoms, and fertility issues in this cohort.

Main Methods:

• A retrospective evaluation of 24 adult patients (aged 18-34 years) treated for PUV between 1982 and 1995 before age 3.
• Data collected via clinical interviews, creatinine clearance tests, uroflowmetry with post-void residual ultrasound, and self-administered questionnaires.
• Surgical history, including endoscopic valve ablation and reconstructive procedures, was reviewed.

Main Results:

• 54.1% of patients developed chronic renal failure, and 37.5% had arterial hypertension.
• 20.8% progressed to end-stage renal disease, with 3 undergoing transplantation and 2 on dialysis.
• 29.1% reported lower urinary tract symptoms; fertility and sexual function were largely preserved, though one patient was azoospermic.

Conclusions:

• Long-term follow-up of patients treated for posterior urethral valves is crucial for managing chronic renal impairment and bladder dysfunction.
• Continuous monitoring of kidney, bladder, and sexual health into adulthood is necessary to detect and manage potential long-term complications.