Posterior urethral valves: the scenario in a developing center

• DOI: 10.1007/s003830000495
• Publication Date: 2002-10-06T15:58:03Z
• Authors: S. K. Chatterjee; S. Banerjee; D. Basak; A. K. Basu; A. K. Chakravarti; U. S. Chatterjee; J. Haque
• Keywords: Vesico-Ureteral Reflux; Urethral Obstruction; Infant, Newborn; Infant; Urinary Diversion; 3. Good health; Cystostomy; 03 medical and health sciences; 0302 clinical medicine; Urethra; Child, Preschool; Humans; Urologic Surgical Procedures; Nephrostomy, Percutaneous

We have reviewed 233 patients with posterior urethral valves treated in a single center in Calcutta, India, over the last 20 years: 37 were neonates, 75 were between 1 and 12 months, 88 were between 1 and 5 years, and 33 were more than 5 years old when first seen. The clinical presentation and methods employed in diagnosis and assessment are described. Primary endoscopic valve ablation was performed in 140 patients (60%). One or other form of diversion was done in 100 (43%), 93 before and 7 either during or after valve ablation. The short- and long-term results have been studied. Eleven patients died during the initial hospitalization, 3 died subsequently, 15 are in end-stage renal disease, 17 are in poor health, and 18 have been totally lost to follow-up. The remaining 169 have been in good health for periods between 1 and 20 years. While our results of primary valve ablation in low-risk patients with responsible parents are as good as anywhere else in the world, we are concerned at our relatively high diversion rate and relatively poor long-term follow up; the methods being adopted to reduce these problems are discussed.