Outcomes of primary valve ablation in posterior urethral valves patients

Abstract

Background : Posterior urethral valves (PUVs) are the most common cause of obstructive uropathy in male children that in long-term can lead to ESRD.

Objectives : The aim of the study was to report outcomes of primary valve ablation in patients with posterior urethral valves.

Design : Descriptive study.

Setting : King Chulalongkorn Memorial Hospital, Bangkok, Thailand.

Materials and Methods : We retrospectively reviewed every medical record of patients diagnosed with posterior urethral valves and treated with primary valve ablation or other modalities at King Chulalongkorn Memorial Hospital from January 2002 to December 2012. Patient’s demographic data, age of presentation, imaged finds, presenting signs and symptoms, complications, and long-term outcomes were recorded.

Results : Forty-four patients were recruited. Their median age of presentation was 12.6 months and median follow-up time was 43 months. Most common presenting symptoms were urinary tract infection (77%), rising serum creatinine, and antenatal diagnosis, respectively. The initial imaging was found as abnormal bladder (84%), hydronephrosis (65.9%), and vesicoureteral reflux (50%). After primary valve ablation, serum creatinine was improved by 81%, hydronephrosis 79.3%, and vesicoureteral reflux 57.1%. Complications were urethral stricture found in 1 patient and urinary retention in another.

Conclusion : Primary valve ablation seems to be safe and effective for treatment of posterior urethral valves. Renal function improved after the treatment, and complication rate was low.