Posterior Uretral Valves. About a series of 44 cases

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Published Aug 4, 2010
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Vol. 88 No. 8 (2010): Issue Aug 2010

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Tahar Gargah
Youssef Gharbi
Mohamed Ben Moussa
Nejib Kaabar
M.Rachid Lakhoua

Abstract

Objectif : To explore the physical symptoms and radiological findings for the diagnosis of posterior urethral valves (PUV), to point of the therapeutic snags depending on gravity and delay of lesions.
Methods: We reviewed the records of 44 patients with PUV. Mean age: 2 years 1/2 (range 1day-13 years). More than 75% of patients were less than 2 years old. RESULTS: In utero diagnosis was made in 8 patients (14%). After birth, the diagnosis was based on urological signs (as frequent as diagnosis is made belatedly) and extra urological signs. Cystourethrography (CUG) showed posterior urethral dilatation in all cases. Ultrasonography (US) showed abnormalities in 30 cases and intravenous urography (IVU), made in 21 cases, was normal in appearance in 7 of them. At diagnosis, it was a renal failure in 36 patients and 8 of them had a terminal renal deficiency. Urethroscopy made in 40 patients, showed PUV in all cases. There were 29 type I valves, 3 type II valves, 5 type III and 3 unclassifiables cases. Treatment was endoscopic in 41 cases and by lamination in the 3 others. Mean follow up is 9 years (range16months-19 years) and 19 patients have terminal renal failure from which 3 are deceased.
Conclusion : PUV are dangerous obstructive uropathies in boy whom end at terminal renal failure in more than 33% of cases. Precocious diagnosis and early ablation of PUV are able to limit the complications inherent to this pathology.

Keywords:

Valves, Posterior urethral, neurogène bladder, endoscopy, renal failure

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