The Outcome of Management of Posterior Urethral Valves
Gajendra Nath Mahato1*, Ipsita Biswas2, Ayub Ali2 and Gouranga Kumar Bose3
1Assistant Professor, Department of Pediatric Urology, Bangladesh Shishu Hospital and Institute, Dhaka, Bangladesh
2Associate Professor, Department of Pediatric Urology, Bangladesh Shishu Hospital and Institute, Dhaka, Bangladesh
3Associate Professor, Assistant Professor Surgery Sheikh Hasina Medical College, Tangail, Bangladesh
*Corresponding Author: Gajendra Nath Mahato, Assistant Professor, Department of Pediatric Urology, Bangladesh Shishu Hospital and Institute, Dhaka, Bangladesh.
April 10, 2023; Published: April 14, 2023
Background: The most common cause of bladder outlet obstruction in infancy are Posterior urethral valves (PUV) that impair renal and bladder function. This study was planned to evaluate and record the various clinical presentations and management, complications, surgical management and long-term outcome of PUV.
Aim of the Study: This study was planned to evaluate and record the various clinical presentations, management, complications, surgical management and long-term outcome of PUV.
Methods: In this study total, 49 patients who have been treated for PUV were evaluated in Bangladesh Shishu Hospital and Institute from May 2018 to April 2022. Complete data were taken, paraclinical examinations were performed on each patient and diagnosis was confirmed by micturating-cysto-urethrography (MCU). Posterior urethral valves had been ablated in all patients by the electric hook.
Results: 49 patients with a mean age at diagnosis of 42 ( ± 21) days were included in this study. Catheterization was done within one to 5 days of life in 29 patients. PUV ablated all 49 patients by the electric hook. The most common symptom in our group was dribbling poor stream 71% and urinary tract infection (UTI) 46%. There was vesico-ureteral-reflux (VUR) in 52% and hydronephrosis in 92.5%. The most common associated anomaly was kidney anomalies (Renal agenesis/dysplasia and multicystic kidney disease) in 4 (8.2%) patients. About ten patients had a prenatal diagnosis of PUV. Complications occurred in two (4.2%) patients. Mortality occurred in 3 (6.4%) patients. The mean follow-up period was 3.2 ± 0.8 years (1.5 months to 4 years).
Conclusion: MCU is the gold-standard imaging modality for documenting PUVs. Urinary drainage by catheter in infancy, followed by valve ablation, is the best treatment for PUV. The factors like renal dysplasia and UTI have their role in the outcome.
Keywords: PUV; Urinary Drainage; Valve Ablation; Urinary Diversion; Outcome; Children
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