Posterior urethral valves: current concepts in diagnosis and treatment

Since 1969 we have treated 10 pediatric cases of posterior urethral valves. Of these patients 5 underwent early upper tract diversion and 5 underwent valve resection and observation. There were no deaths and no patients with permanent urinary diversion. All patients in whom blood pressure was recorded were hypertensive preoperatively and normotensive postoperatively. Creatinine clearances stabilized or improved in all but 1 case, although the urogram findings did not correlate well with improved clearance. Dilatation of the upper tracts resolved slowly in all cases. The current treatment should include early valve resection or fulguration followed by observation with emphasis on renal function, blood pressure and infection as opposed to the urographic appearance of the collecting system.