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2009 ; 9
(ä): 1119-26
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Posterior urethral valves
#MMPMID19838598
Hodges SJ
; Patel B
; McLorie G
; Atala A
ScientificWorldJournal
2009[Oct]; 9
(ä): 1119-26
PMID19838598
show ga
The most common cause of lower urinary tract obstruction in male infants is
posterior urethral valves. Although the incidence has remained stable, the
neonatal mortality for this disorder has improved due to early diagnosis and
intensive neonatal care, thanks in part to the widespread use of prenatal
ultrasound evaluations. In fact, the most common reason for the diagnosis of
posterior urethral valves presently is the evaluation of infants for prenatal
hydronephrosis. Since these children are often diagnosed early, the urethral
obstruction can be alleviated rapidly through catheter insertion and eventual
surgery, and their metabolic derangements can be normalized without delay,
avoiding preventable infant mortality. Of the children that survive, however,
early diagnosis has not had much effect on their long-term prognosis, as 30%
still develop renal insufficiency before adolescence. A better understanding of
the exact cause of the congenital obstruction of the male posterior urethra,
prevention of postnatal bladder and renal injury, and the development of safe
methods to treat urethral obstruction prenatally (and thereby avoiding the
bladder and renal damage due to obstructive uropathy) are the goals for the care
of children with posterior urethral valves[1].
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