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Posterior urethral valves: a report of five cases
Y Y Chang1, H C Peng, H C Chen
1Division of Urology, Taichung Veterans General Hospital, Taiwan, R.O.C.
Zhonghua Yi Xue Za Zhi = Chinese Medical Journal; Free China Ed
|June 1, 1995
Summary
Posterior urethral valves (PUV) in male children can cause severe urinary tract issues. Surgical ablation of PUV effectively restored renal function in most cases, though long-term monitoring is essential.
Area of Science:
- Pediatric Urology
- Nephrology
- Surgical Innovation
Background:
- Posterior urethral valves (PUV) are a common congenital anomaly in male infants, leading to bladder outlet obstruction.
- Severe PUV can cause significant upper urinary tract damage, including hydronephrosis and hydroureter, even in newborns.
Observation:
- This study reviewed five male patients (newborns to 10 years) with Type I PUV, all presenting with severe bilateral hydronephrosis and hydroureter.
- Voiding cystourethrogram revealed prostatic urethral dilatation and bladder wall trabeculation; only one patient had vesicoureteral reflux.
Findings:
- Retrograde transurethral ablation was successful in four patients with good preoperative renal function.
- Postoperative complications included vesicoureteral reflux (managed with ureteral reimplantation) and systemic fungal infection (treated with amphotericin B).
- One newborn with poor renal function and ascites underwent successful delayed antegrade ablation after initial cutaneous vesicostomy.
Implications:
- Transurethral ablation is an effective treatment for posterior urethral valves, restoring renal function.
- Management of complications like VUR and fungal infections is crucial for successful outcomes.
- Long-term follow-up is necessary to assess upper urinary tract function and bladder continence post-treatment.