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Pop-Off Mechanism in Posterior Urethral Valve (Abstract)

Diary A. Rahman, Maher A. Ghazala, Mamoun Al Marzouqi, A.R. Mustafawi,
Department of Paediatric Surgery  
Al Wasl Hospital, Dubai, United Arab Emirates.



Aim: To report Al Wasl Hospital experience with diagnosis and management of patients with “pop-off” mechanism in posterior urethral valves.

Materials and Methods: From January 2000 through January 2005, the records of 17 patients with posterior urethral valve (PUV) were evaluated retrospectively in the department of paediatric surgery, Al Wasl Hospital, Dubai, United Arab Emirates. Radiological studies were reviewed, eight patients with “pop-off” mechanism were abstracted.

Results: All patients had PUV with urinary diverticulum in one patient, three patients presented with urinary ascites, bilateral urinoma in the first two patients and left peri-renal urinoma in the third patient. MCUG showed left VUR and bilateral VUR in the last two patients respectively. In the remaining four patients, the “pop-off” mechanism presented as left VUR with poor functioning left kidney in all of them ranging from 0-14% function. One patient also had right vesico-ureteric junction obstruction. All patients were operated as valve ablation, one patient had urinary diverticulectomy, one patient had left ureterostomy, vesicostomy in two patients. Two patients had left nephro-ureterectomy with histological changes of dysplasia. In one patient, right ureteric DJ stent was inserted to overcome right VUJ obstruction. Postoperatively all except one have excellent renal function.

Conclusion: The presence of a pressure “pop-off” mechanism in PUV is a favourable prognostic sign.


Key words: Posterior Urethral Valve, pop-off mechanism, renal function


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