An antegrade technique for ablation of posterior urethral valves

Complications after transurethral ablation of posterior urethral valves frequently are iatrogenic because of urethral injury resulting in stricture or sphincteric incontinence. Smaller instrumentation and improved optics have made primary valve destruction safer and more reliable. The concept of early neonatal vesicostomy with delayed transurethral valve ablation allows maximal upper tract protection as well as somatic and urethral growth. This approach further reduces the possibility of urethral or sphincteric injury. We report our technique of antegrade incision of posterior urethral valves per vesicostomy, combining the advantages of early optimal neonatal vesicostomy drainage, avoidance of any anterior urethral instrumentation, and a technically easier, reliable and safe approach to posterior urethral valve destruction.