Posterior Urethral Valves: Experience from a tertiary teaching hospital in Eastern India
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2017, Vol 17, Issue 2
Abstract
Context: The most common cause of bladder outlet obstruction in male infants is posterior urethral valves (PUV) which causes functional impairment of kidney and bladder. Aims: This study was planned to analyze various clinical presentations, complications, surgical management and outcome of PUV. Methods and Material: 30 patients treated for PUV in the Department of Urology, Nil Ratan Sircar Medical College and Hospital, Kolkata from January-2015 to November-2017, have been retrospectively evaluated. Results: A total of 30 patients with mean age at diagnosis of 6.7 years were included in this study. The most common presenting symptom was dribbling of urine in 93.33% while 83.3% had a palpable bladder. Abdominal ultrasonogram detected bilateral hydronephrosis in 66.6% patients and thickened bladder wall in 56.66%. VCUG done in all patients revealed a dilated posterior urethra. There was associated vesico-ureteral reflux in 33% patients. Urinary tract infection was detected in 66.6% patients. Mean serum creatinine at presentation was 1.81mg/dl (range 0.6-6.2 mg/dl). All patients underwent endoscopic valve ablation and were followed up. All patients had significantly improved stream and 15 out of 20 culture-positive patients became culturenegative at 1 month follow up. Mean serum creatinine at 3 months follow-up was 1.38mg/dl (range 0.6- 3.2mg/dl). Conclusions: Urinary drainage by feeding tube in early infancy, followed by valve ablation is the best treatment in PUV. VCUG is the gold-standard imaging modality for diagnosis. Factors like late presentation and renal dysplasia have their role in final outcome. Parents need to be counselled regarding early presentation and close follow-up.
Authors and Affiliations
Shashanka Dhanuka1, Tapan Kumar Mandal2, Maharaj Mondal3, Ankit Kayal4 ,, Bibhas Chandra Mukhopadhyay5
Keywords
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- EP ID EP365279
- DOI 10.9790/0853-1702153437
- Views 60
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