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The posterior urethral valves: about 50 cases

Souhem Touabti, Soualili Zineddine

Hospital University, Setif, Algeria



Summary: The posterior urethral valves (PUV) are the most common obstructive uropathy of the boy. It is a serious defect because that can lead to destruction of renal parenchyma and kidney failure.
Aim: To clarify taken surgical careof this uropathy.
Patients and methods: All children, managed for PUV during aperiodof 10 years (January 2000 to December 2010)
Results: A total of 50 boys were studied. Their age ranged from one day to 02 years. The diagnosis was made prenatally in 30 cases and postnatally in the remaining cases during a urinary tractinfection in 20 cases and voiding disorders in the remaining cases. All these children were investigated by renal ultrasound and retrograde cystourethrography (RCUG). Ultrasonography showed a bilateral uretero-hydronephrosis in 45 cases and unilateral in 05 patients with reduced renal parenchyma in 25 cases. The RCUG made the diagnosis of PUV in all cases, showing adilated posterior urethra and distended bladder. Bladder diverticulum was seen in 25 cases and a vesicoureteral reflux (VUR) was present in 32 cases DMSA renal scintigraphy performed in 28 cases showed decreased uptake of cortical lesions in all cases with a non-functioning kidney in 12 cases. In addition to the correction of electrolyte disturbances and the appropriate antibiotics in case of urinary tract infections, treatment consisted of a first valve endoscopic section in 37 cases and a cystostomy in 13 cases. The immediate evolution was favourable in all cases, excepttwo patients who died because of acute renalfailure despite intensive resuscitation.
Conclusion: Despite advances in diagnosis and management of posterior urethral valves, the prognosis of this uropathy remains subject to a significant risk of progression to ESRF