Diagnosis
and treatment of PUV

Differential diagnosis of PUV

Confirmation of the diagnosis of PUV is made by cystoscopy.
In children with an abnormally thick-walled and trabeculated bladder, differential diagnoses are:

  • Neurogenic bladder
  • Prune belly syndrome
  • Difficulty with voiding, weak urinary stream
  • obstruction of the bladder outlet
  • Urethral atresia

Treatment of PUV

  • Stabilization of the patient and drainage of the urinary tract.
  • Correction of electrolyte abnormalities.
  • Treatment for possible complications such as respiratory distress and urinary tract infection.
  • Endoscopic incision or puncture
  • Upper pole heminephrectomy w/no lower tract reconstruction: In patients with ureteroceles who have a non-functioning upper segment and low-grade or no VUR
  • Upper pole heminephrectomy w/ lower tract reconstruction (combined approach): in patients who clearly have no function of the upper pole system but high-grade reflux into the ipsilateral lower pole ureter or contralateral ureter
  • Ureteroureterostomy +/-reimplant combined
Obstructive uropathies | 3. Mastering the treatment of obstructive uropathy
34 / 35
34 / 35