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Congenital ureteric valves--a cause of urinary obstruction
Insights
Congenital ureteric valves can cause upper urinary tract obstruction in adults and infants. Early diagnosis and surgical intervention, including valve excision and ureteric reconstruction, are crucial for managing this condition.
Area of Science:
- Urology
- Pediatric Urology
- Surgical Innovation
Background:
- Congenital ureteric valves are rare anomalies.
- They can lead to significant upper urinary tract obstruction.
Observation:
- Five patients (4 adults, 1 infant) presented with urological issues.
- Adults had varied urological problems, while the infant showed failure to thrive.
- The infant had suspected congenital ureteric valve and gross hydronephrosis.
Findings:
- Surgical intervention was required for all patients.
- The infant underwent valve excision, ureteric anastomosis, and pyeloplasty.
- Three adults with severe kidney damage required nephrectomy.
- One adult with horseshoe kidney and stones underwent pyelolithotomy, valve excision, and ureteropyelostomy.
Implications:
- Congenital ureteric valves should be considered in the differential diagnosis of upper urinary tract obstruction.
- Prompt surgical management can prevent irreversible kidney damage.
- Surgical techniques vary based on patient age and associated anomalies.
Abstract:
Congenital ureteric valves causing upper urinary tract obstruction was discovered after operation in 4 adults who had presented with different urological problems. The fifth patient, an infant, presented with failure to thrive and was suspected of having a congenital ureteric valve prior to operation. The infant had gross hydronephrosis and was treated by excision of the segment containing the valve and end-to-end anastomosis of the ureter and pyeloplasty because of a narrow pelviureteric junction. Three adults had severe kidney damage and underwent nephrectomy. The fourth adult, who had a horseshoe kidney with 4 small stones in the lowermost calix, underwent pyelolithotomy; in addition, the segment bearing the valve was excised and a ureteropyelostomy was carried out.