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Posterior Urethral Valves; A single Center Experience.
Alireza Mirshemirani1, Ahmad Khaleghnejad1, Mohsen Rouzrokh1
1Pediatric Surgery Research Center, Shaheed Beheshti University of Medical Sciences, Tehran, Iran.
Iranian Journal of Pediatrics
|May 7, 2014
Summary
Early urinary drainage and valve ablation, followed by diversion, offers the best outcomes for infants with posterior urethral valves (PUV). Voiding cystourethrography remains the gold standard for PUV diagnosis.
Area of Science:
- Pediatric Urology
- Medical Imaging
- Surgical Management
Background:
- Posterior urethral valves (PUV) are a primary cause of bladder outlet obstruction in infants.
- PUV can lead to significant impairment of renal and bladder function.
- Understanding clinical presentations and management is crucial for infant health.
Purpose of the Study:
- To evaluate clinical presentations of posterior urethral valves (PUV).
- To record management strategies, complications, and surgical outcomes.
- To assess the long-term prognosis for infants diagnosed with PUV.
Main Methods:
- A retrospective study of 98 patients treated for PUV from 2007-2012.
- Diagnosis confirmed via voiding-cysto-urethrography (VCUG).
- Analysis of clinical data, management (ablation/diversion), and outcomes.
Main Results:
- Common symptoms included poor stream (51%) and urinary tract infections (UTI) (40.8%).
- High rates of vesico-ureteral reflux (VUR) (61.2%) and hydronephrosis (82.6%) were observed.
- Associated anomalies and complications were noted, with a 5.1% mortality rate.
Conclusions:
- Early urinary drainage and valve ablation, with subsequent urinary diversion, represent optimal treatment for PUV.
- VCUG is confirmed as the gold-standard for PUV diagnosis.
- Renal dysplasia and UTIs significantly impact the final patient outcomes.
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