Follow-up of 50 children after posterior urethral valve management in Al-Azhar University Hospitals

Abstract

Objective: This study was performed to assess the various clinical presentations, complications, and surgical management, as well as follow-up, of patients with posterior urethral valve (PUV).

Patients and methods: This is a prospective descriptive analysis of the data of 50 patients with PUVs of different age reviewed. Serum creatinine levels, clinical examination, abdominopelvic ultrasound, and magnetic resonance urography were performed, and the diagnosis was confirmed
by voiding cystourethrography. The patients were divided into two categories: primary intervention and surgical intervention.

Results: A total of 50 boys with a mean age at diagnosis of 100 ±15 days were included in this work. The most common presentation in patients managed by valve ablation was difficult micturition (60%), whereas in patients managed by initial vesicostomy the most common presentation was febrile urinary tract infection (67%). Vesicoureteral reflux presented in 61.2% and hydronephrosis in 82.6%, whereas complications occurred in three (6%) children. Mortality occurred in five (10%) patients. Postoperative improvement of hydronephrosis grade in both categories is not appreciably different.

Conclusion: Urinary drainage using small catheters or nasogastric tube in the early days of infancy followed by valve ablation is the best treatment modality in PUV.

Keywords: children, outcome, posterior urethral valve, urinary drainage valve ablation, vesicostomy