Posterior urethral valves in the newborn: treatment and functional results

Between 1977 and 1984, 30 newborn boys were diagnosed and treated with posterior urethral valves. Presenting symptoms varied but included respiratory distress, oligohydramnios, urinary ascites, abdominal mass, urinary retention, and renal insufficiency. Diagnostic modalities consisted of excretory urography and voiding cystourethrography in all patients and ultrasonography in 20 (12 prenatal). Treatment consisted of valve ablation alone in 14, vesicostomy and later valve ablation in 4 premature infants, valve ablation and later upper tract reconstruction in 8, loop ureterostomy in 2, and valve ablation and immediate reconstruction in 2. Follow-up in our patients has demonstrated that even though surgical reconstruction may be technically successful, ultimate functional outcome may be dependent upon the degree of renal impairment at presentation.