[Persistent urinary incontinence after posterior urethral valve endoscopic section in boys. Urodynamic study...

Urinary incontinence persisted in 8 boys of school age after posterior urethral valve endoscopic section. An essential fact is that all the boys had urinary incontinence before operation. Other lesions, particular infection, vesico-ureteral, reflux, or upper urinary tract affections, were absent. The obstructive nature of the urethral valves was suggested by the clarity of the valvular image on radiography, moderately increased vesical pressure during micturition, and supravalvular dilatation of the posterior urethra. Postoperative micturition urethrography was normal in nearly all cases, and yet urinary incontinence from vesical instability, as demonstrated by dynamic tests in each child, persisted unchanged. The authors consider that in children shown to have a posterior urethral valve with urinary incontinence from vesical instability, and in the absence of other manifestations apart perhaps from some dysuria, endoscopic section of the valve may modify micturition, but cannot completely suppress vesical instability. The persistence of this instability could be the cause of the continuing incontinence.