Posterior urethral valves in Saudi Arabia

Area of Science:

• Pediatric Urology
• Surgical Outcomes
• Congenital Anomalies

Background:

• Posterior urethral valves (PUV) are a common cause of bladder outlet obstruction in male infants.
• Management of PUV requires timely diagnosis and effective intervention to prevent long-term renal damage.
• Early surgical outcomes and complications associated with PUV management have been historically variable.

Purpose of the Study:

• To review the management and outcomes of patients with posterior urethral valves treated at a tertiary care center.
• To evaluate the efficacy of primary transurethral valve ablation versus other surgical approaches.
• To assess the incidence and resolution of vesicoureteric reflux following PUV treatment.

Main Methods:

• Retrospective review of 40 patients diagnosed with posterior urethral valves between 1977 and 1983.
• Diagnosis confirmed by voiding cystourethrography and endoscopic evaluation.
• Surgical interventions included primary transurethral valve ablation and cutaneous vesicostomy followed by valve ablation.

Main Results:

• 72% of patients were under one year of age at diagnosis.
• Primary transurethral valve ablation in 16 patients resulted in satisfactory outcomes for 15 (93.75%).
• Vesicoureteric reflux occurred in 62.5% of cases, resolving spontaneously in one-third; 9 patients required reimplantation, and 6 underwent nephroureterectomy.

Conclusions:

• Primary transurethral valve ablation is a highly effective initial treatment for posterior urethral valves.
• While vesicoureteric reflux is common, it often resolves spontaneously or with temporary diversion.
• Aggressive management strategies can lead to favorable outcomes without hospital mortality.