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Consensus on the Management of Posterior Urethral Valves from Antenatal Period to Puberty

Shilpa Sharma1, Manoj Joshi2, Devendra K Gupta1

  • 1Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, India.

Journal of Indian Association of Pediatric Surgeons
|January 29, 2019
PubMed

Insights

Successful management of posterior urethral valves in children requires comprehensive care, from prenatal preservation to long-term follow-up. This consensus outlines best practices for pediatric surgeons managing this complex condition.

Area of Science:

  • Pediatric Surgery
  • Urology
  • Nephrology

Background:

  • Posterior urethral valves (PUV) pose significant management challenges in pediatric surgery.
  • Despite optimal care, some cases progress to end-stage renal disease.
  • Effective management requires addressing prenatal, surgical, and long-term follow-up aspects.

Purpose of the Study:

  • To establish consensus-based standard operating procedures for managing posterior urethral valves.
  • To provide guidelines for pediatric surgeons in India.
  • To optimize outcomes and prevent secondary renal damage in children with PUV.

Main Methods:

  • Consensus development through questionnaires distributed to experienced pediatric surgeons.
  • Discussion and formulation of standard operating procedures for diagnostic procedures.
  • Literature review to supplement consensus guidelines.

Main Results:

  • Standardized procedures for voiding cystourethrogram and cystoscopy were formulated.
  • Age-wise contrast dosage recommendations were established.
  • A comprehensive approach to PUV management, including long-term care, was outlined.

Conclusions:

  • A unified approach based on consensus and evidence is crucial for successful posterior urethral valve management.
  • Standardized protocols can improve outcomes and prevent renal damage.
  • Continuous follow-up and management of valve bladder syndrome are essential.

Keywords:
Antenatal obstructive uropathychronic kidney diseaseposterior urethral valvesrenal dysplasiavalve bladder

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