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DELAYED PRESENTATION OF POSTERIOR URETHRAL VALVES: A NOT SO BENIGN CONDITION

1999; Lippincott Williams & Wilkins; Volume: 162; Issue: 6 Linguagem: Inglês

10.1016/s0022-5347(05)68140-2

1527-3792

M. David Bomalaski, John Anema, D.E. Coplen, Harry P. Koo, Thomas A. Rozanski, David A. Bloom,

Urinary and Genital Oncology Studies

No AccessJournal of UrologyPEDIATRIC UROLOGY1 Dec 1999DELAYED PRESENTATION OF POSTERIOR URETHRAL VALVES: A NOT SO BENIGN CONDITION M. DAVID BOMALASKI, JOHN G. ANEMA, DOUGLAS E. COPLEN, HARRY P. KOO, THOMAS ROZANSKI, and DAVID A. BLOOM M. DAVID BOMALASKIM. DAVID BOMALASKI , JOHN G. ANEMAJOHN G. ANEMA , DOUGLAS E. COPLENDOUGLAS E. COPLEN , HARRY P. KOOHARRY P. KOO , THOMAS ROZANSKITHOMAS ROZANSKI , and DAVID A. BLOOMDAVID A. BLOOM View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)68140-2AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Posterior urethral valves are usually detected during infancy by prenatal sonography. Rarely they may be diagnosed during later childhood, adolescence or even adulthood. Less is known about presentation and outcome in these older patients. We reviewed our experience at 4 institutions with the late presentation of posterior urethral valves. Materials and Methods: A 13-year retrospective review revealed the late presentation of posterior urethral valves in 47 patients 5 to 35 years old (mean age 8). Data collected included presenting symptomatology, radiographic findings and renal function. Statistical analysis determined the relationships among presenting symptoms, patient age at diagnosis and renal function. Results: The most common presenting symptoms were diurnal enuresis in 60% of the cases, urinary tract infection in 40% and voiding pain in 13%. Other presenting symptoms in less than 10% of the cases included poor stream, gross hematuria and proteinuria. At diagnosis hydronephrosis and vesicoureteral reflux were present in 40 and 33% of the patients, respectively, while serum creatinine was elevated in 35% and end stage renal disease had developed in 10%. The severity of presenting signs and symptoms was significantly associated with renal impairment, while patient age at diagnosis was not. Conclusions: Posterior urethral valves is not merely a disease of infancy. Voiding cystourethrography should be considered in boys older than 5 years who have voiding complaints, especially in association with diurnal enuresis or urinary tract infection. Patients who present late with posterior urethral valves are at risk for progression to end stage renal disease. References 1 : Early ureteral surgery for posterior urethral valves. Urol. Clin. N. Amer.1990; 17: 361. Google Scholar 2 : Posterior urethral valves in the British Isles: a multicenter BAPS review. J. Paed. Surg.1993; 18: 70. Google Scholar 3 : Posterior urethral valves presenting as postejaculatory dysuria in a 26-year-old physician. J. Urol.1998; 160: 126. Link, Google Scholar 4 : Long term clinical outcome of boys with posterior urethral valves. Brit. J. Urol.1988; 62: 59. Google Scholar 5 : Posterior urethral valves in boys: a broad clinical spectrum. J. Urol.1971; 106: 298. Link, Google Scholar 6 : Blood chemistries. 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Urol.1996; 155: 1730. Link, Google Scholar From the San Antonio Uniformed Services Health Care Consortium, San Antonio, Texas, St. Louis Children’s Hospital, St. Louis, Missouri, and University of Michigan, Ann Arbor, Michigan© 1999 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byEngel D, Pope J, Adams M, Brock J, Thomas J and Tanaka S (2011) Risk Factors Associated With Chronic Kidney Disease in Patients With Posterior Urethral Valves Without Prenatal HydronephrosisJournal of Urology, VOL. 185, NO. 6S, (2502-2506), Online publication date: 1-Jun-2011.Ziylan O, Oktar T, Ander H, Korgali E, Rodoplu H and Kocak T (2018) The Impact of Late Presentation of Posterior Urethral Valves on Bladder and Renal FunctionJournal of Urology, VOL. 175, NO. 5, (1894-1897), Online publication date: 1-May-2006. Volume 162Issue 6December 1999Page: 2130-2132 Advertisement Copyright & Permissions© 1999 by American Urological Association, Inc.Keywordsurinary tract infectionskidney failure, chronicabnormalitiesurethraenuresisMetricsAuthor Information M. DAVID BOMALASKI More articles by this author JOHN G. ANEMA More articles by this author DOUGLAS E. COPLEN More articles by this author HARRY P. KOO More articles by this author THOMAS ROZANSKI More articles by this author DAVID A. BLOOM More articles by this author Expand All Advertisement PDF downloadLoading ...