Presentation, Management and Out Come of Children with Posterior Uretheral Valve
Keywords:Posterior urethral valve, micturating cystourethragram, renal failure, reflux nephropathy, bladder dysfunction.
The purpose of this study was to analyze the different presentations of the children with posterior urethral valve, their management and outcome, This prospective study was carried out for the period of six years starting from April 1994. A total of 51 children presented with the diagnosis of posterior urethral valve during the period of six years with the mean age of 43 months. Bladder dysfunction was the major primary presenting symptom in 043% children (n=22) followed by renal failure in 25% patients (n=13) and pain in suprapubic region with distended bladder in 13.7 % children (n7). Of the 22 patients of bladder dysfunction 09 patients came out to be in renal failure after investigation with the total incidence of renal failure of 43%. MCU revealed posterior urethral valve in all patients, bilateral reflux in 08 patients and unilateral reflux in 23 cases. Endoscopic ablation of the posterior urethral valve was performed in all patients. Reimplantation of the ureter was done in cases with grade 4 or 5 reflux. Posterior urethral valves (PUV) are overwhelmingly the most common, specific diagnosis affecting boys. These children are at high risk of renal failure. This can all be avoided by early diagnosis and management as well as consideration of the disease at all levels so that early referral to the tertiary care centers can be made possible.
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