[Posterior urethral valves in children. Apropos of 22 cases]

We reviewed 22 cases of posterior urethral valves over a five year period (January 1986 to December 1990). We looked at initial management before referral to the urologist, treatment and those factors that influence the outcome. We found that nosocomial infection from catheters was the major source of morbidity and mortality. Other determinants of outcome included postobstructive diuresis and the presence of refluxing or obstructing megaureters. The age of the patients was not as important as the degree of obstruction in this group of patients. We recommend percutaneous cystostomy as initial management for these patients as opposed to urethral catheterisation. This should be followed by antegrade or retrograde valve ablation one week later depending on the size of urethra.