The outcome of posterior urethral valves: a twenty one year experience

Abstract

Background: Posterior urethral valves (PUV) result in a spectrum of obstruction, and up to thirty percent of patients progress to renal failure. Objective: Descriptive study of patients with PUV, and to compare growth and renal function in the primary valve ablation versus vesicostomy group. Methods: Retrospective record review of patients with PUV at Chris Hani Baragwanath Hospital from January 1985 to December 2005. Results: A total of 128 boys were identified. The mean (range) age was 12.9 months (0 to 139.4). The mean duration of follow-up was 42 months, with 65% lost to follow- up. UTI and voiding problems were the most common modes of presentation. Young age at presentation and renal dysfunction after surgery were poor prognostic features. Hydronephrosis was present in 89.5%. Renal failure was present in 37% of patients at last visit. Primary valve ablation was performed in 44.2% and vesicostomy in 55.8%. No statistical difference in renal outcome or somatic growth was observed between the surgical groups. Conclusion: PUV is a common condition with significant morbidity. The renal outcome in black South African boys is similar to reports from developed countries. The type of initial surgical management did not impact on renal outcome or somatic growth.