Posterior urethral valve clinical assessment and outcome

Abstract

Background: Posterior urethral valves are the most common cause of infra-vesical obstruction in the male child. A posterior urethral valve (PUVs) represents the most common etiology for congenital urethral obstruction and the most common congenital cause for bilateral renal obstruction and somatic growth retardation. It is also the most common cause of obstructive uropathy leading to childhood renal failure. With an estimated incidence of 1/5000 to 1/8000 male births, they account for 10% of all prenatally diagnosed urinary obstructions. The aim & objective of present study is to find out the incidence, age & modes of clinical presentation relevant investigations and different management in cases with diagnosed posterior urethral valve and its short term outcome. Materials & Methods: Study was carried out in MGM Medical College & LSK Hospital Kishanganj Bihar India. It is a retrospective study of the patients who were managed from September 2016 to August 2018 and followed up in our department. Results: Out of 50 patients, 100% patients presented with poor urinary poor urinary stream followed by dribbling of urine and palpable bladder, 54% presented with recurrent UTI. About 66% patients had presented with fever and 7 patients presented with features of renal failure. We had; done primary cystoscopic valve fulguration in 41 cases (82%) and vesicostomy followed by cystoscopic fulguration in rest of 9 cases (18%). Conclusion: Posterior urethral valve is a dynamic disease that can have lifelong effects on bladder. These patients need long term follow up care to monitor and treat the effects of altered bladder compliance