POSTERIOR URETHRAL VALVES

Abstract

Posterior urethral valves are the most common cause of mechanical infra
vesical obstruction in children. The disorder has a broad spectrum of severity and the patients could develop
complications on the long term, even after valves ablation. Objective: To record the various clinical presentations of
PUV and audit our experience in management of PUV and its various complications. Study design: Prospective study
Setting: Department of Urology Allied Hospital Faisalabad. Period: From 01-01-2001 to 31-07-2004. Material &
Methods: All male patients (children, infants & neonates) presented with various symptoms and signs of PUV were
included in the study. Detailed history & clinical examination was performed in each case. Diagnosis was confirmed
by micturating Cystourethrogram. Posterior urethral valves were ablated in all patients by electric hook. The period of
follow-up was 06 months. Results: Total number of patients were 32. Age of presentation was 40 days to 27 years.
Majority 14(44%) of patients presented with urinary retention.13 (41%). Patients presented with dribbling of urine and
poor stream. 07(22%) had associated vesicouretral reflux. Vesicostomy was performed in one patient and one patient
had to be dialyzed. Complications occurred in 13 (14%) patients. Most common were urinary tract infections in 10 (31%)
patients. One patient went into End stage renal disease. Conclusions: Valve ablation is the mainstay of treatment
of post urethral valves. Prenatal and postnatal factors like renal dysplasia and UTI have their role in final outcome.
Drainage by feeding tube and Vesicostomy improves the outcome.