Posterior Urethral Valves

Renal and urinary issues

  • The incidence of PUV has been variably estimated at between 1 in 3000 and 8000 live male births and is the most common congenital cause of lower urinary tract obstruction.
  • Even with early ablation or prenatal intervention, many patients continue to manifest the classic valve bladder syndrome later in life, with progressive bladder and renal functional deterioration.
  • Valve bladders are characteristically small, thick walled, poorly compliant bladders with chronic overdistention caused by incomplete emptying.

Reasons for follow-up

Incomplete emptying is attributable to detrusor function and drainage from dilated upper tracts.

Renal concentrating abnormalities contribute to polyuria, and patients demonstrate decreased bladder sensation.

Patients’ function is improved by overnight catheter drainage, with or without daytime catheterization.

Patients with PUV require long-term monitoring of their renal function with urologists and nephrologists, and they demonstrate a lifetime cumulative risk of progression to end-stage renal disease.

Up to one-third of patients develop renal failure by early adulthood, and still more develop renal failure later in adult life.

Transitional urology
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