Treatment of Posterior Urethral Valves with the Forgarty Catheter: Experience of the Pediatric Surgery

Abstract

Background. Posterior urethral valves are membranous folds that obstruct urine output. The treatment is multidisciplinary.

Aim: To describe the results of valves destruction using the Fogarty catheter.

Patients and Methods: This was a retrospective and descriptive study ranging from January 1st, 2014 to December 31th, 2020 in all boys admitted for posterior urethral valves confirmed by retrograde urethrocystography and treated in the department of pediatric surgery by Fogarty valve destruction technique. After the treatment the patients were followed for a period of 6 months with an ultrasound and serum creatinine level. The chi square test was used to discuss the results with a significance threshold of p≤ 0.05

Results: In 7 years we managed 82 cases of posterior urethral valves. The average age of our patients was 9.1± 14.73 months (1 day and 72 months). The mean serum creatinine level was 97.38 ±133.35 μmol/L.  A vesico-ureteral reflux was associated with the urethral valves in 29.3% and a vesical diverticulum in 32.9%. Bilateral ureterohydronephrosis was noted in 61%. After 3 months of follow-up the serum creatinine level remained high in 13.4% and a vesico-ureteral reflux persisted in 18.3% of cases. The mean time to valve destruction was 57 ±4.15 days (1 and 660 days). During six months of survey our success rate was 70.7%. Urinary tract infection was noted in 19.5%, and the mortality rate was 9.76%.

Conclusion: Although an alternative method, valves destruction technique by the Fogarty probe can give satisfactory results. The rapid diagnosis and treatment of valves will help to improve the prognosis.