Posterior Urethral Valves: Fetal and Neonatal Aspects
Posterior urethral valves (PUV) are the most common form of urethral obstruction. The disease occurs in 1:5000–1:8000 live male neonates . PUV are a significant cause of perinatal mortality and one of the most common causes of kidney failure in infancy and childhood (a third of the patients suffering from PUV progress to terminal kidney failure during life, and PUV constitute 15% of children undergoing renal transplantation). Grade 5 kidney failure is rare (7:1,000,000 neonates), but is determined almost exclusively by PUV/fetal urethral obstruction and bilateral renal hypoplasia/dysplasia. Survival of such neonates in dialysis is possible in modern referral centers: around 80% survive till preschool age , but at the cost of a very high morbidity and the need for renal transplantation in young children.
- 8.Odeh R, Noone D, Bowlin PR, Braga LH, Lorenzo AJ. Predicting risk of chronic kidney disease in infants and young children at diagnosis of posterior urethral valves: initial ultrasound kidney characteristics and validation of parenchymal area as forecasters of renal reserve. J Urol. 2016;196:862–8.CrossRefGoogle Scholar
- 14.Klein J, Lacroix C, Caubet C, Siwy J, Zurbig P, Dakna M, Muller F, Breuil B, Stalmach A, Mullen W, Mischak H, Bandin F, Monsarrat B, Bascands JL, Decramer S, Schanstra JP. Fetal urinary peptides to predict postnatal outcome of renal disease in fetuses with posterior urethral valves (PUV). Sci Transl Med. 2013;5:198ra106.CrossRefGoogle Scholar
- 16.Ruano R, Sananes N, Sangi-Haghpeykar H, Hernandez-Ruano S, Moog R, Becmeur F, Zaloszyc A, Giron A, Morin B, Favre R. Fetal intervention for severe lower urinary tract obstruction: a multicenter case-control study comparing fetal cystoscopy with vesicoamniotic shunting. Ultrasound Obstet Gynecol. 2015;45:452–8.CrossRefGoogle Scholar
- 25.Mandal S, Goel A, Kumar M, Singh MK, Singh V, Sankhwar SN, Singh BP, Dalela D. Use of Holmium: YAG laser in posterior urethral valves: another method of fulguration. J Pediatr Urol. 2013;9:2093–7.Google Scholar