Posterior urethral valves: an update and review.

Abstract

Here, in a comprehensive review of an important pediatric problem, the authors discuss the embryology, the clinical and radiological features, the complications and the management of posterior urethral valves.

Timing of posterior urethral valve diagnosis and its impact on clinical outcome

“…PUVs can therefore elude diagnosis, even postnatally. The classic history of a weak urinary stream is reported in less than 30% of cases [6]. A diagnostic dilemma can be caused in cases with mild obstruction, as occurred in 23% (10/43) of our patients (1 in group I and 9 in group II).…”

“…The visualization of the dilated posterior urethra, with or without identification of the valve itself, may be technically difficult. A review of [6]. PUVs can therefore elude diagnosis, even postnatally.…”

Abdominal distention and renal failure in a neonate

“…Patients who are not diagnosed prenatally usually present during the neonatal period or during infancy. The initial presentation commonly includes urinary tract infection, weak urine stream or difficulty urinating,5 though the range of presentation is highly variable. Some patients may be asymptomatic while others may present with a toxic appearance owing to abdominal distension secondary to bladder distention or urinary extravasation 5.…”

Prenatal sonographic diagnosis of posterior urethral valves: Identification of valves and thickening of the posterior urethral wall

“…4 A 1986 review of 47 cases of PUV indicated that only a third are diagnosed in the neonatal period and another third during the remainder of the 1st year of life. 6 PUVs can, therefore, elude diagnosis, even postnatally. The classic history of a weak urinary stream is reported in less than 30% of cases.…”