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Posterior Urethral Valves

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Urological Emergencies

Part of the book series: Current Clinical Urology ((CCU))

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Abstract

Posterior urethral valves (PUVs) can be a urologic emergency for newborns. Most of these patients are diagnosed prenatally. The urethral obstruction is initially relieved with a pediatric feeding tube as a catheter. Patients can present through adolescence with hypertension, renal disease, weak urinary stream, hematuria, or urinary incontinence. Endoscopic valve ablation, vesicostomy, or supravesical diversion can all be used for definitive treatment depending on the patient’s characteristics and medical comorbidities.

Despite immediate treatment and early relief of obstruction, many of these patients will develop bladder dysfunction, chronic kidney disease, and end-stage renal disease. Unfortunately, the renal dysplasia associated with PUVs is irreversible and responsible for the renal dysfunction. Appropriate follow-up imaging and timely laboratory testing are essential for proper long-term medical management of these patients. If renal failure does develop, PUV patients are good candidates for renal transplant but their bladder function must be carefully monitored and optimized.

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Authors and Affiliations

  1. Department of Urology, Harvard Medical School, Boston Children’s Hospital, Boston, MA, USA

    Hiep T. Nguyen

  2. Department of Urology, University of Washington, Seattle, WA, USA

    Daniel Avery

  3. Department of Urology, University of Washington School of Medicine and Seattle Children’s Hospital, 1959 NE Pacific Street, Seattle, WA, 98195, USA

    Byron Joyner

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  1. Hiep T. Nguyen
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  2. Daniel Avery
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  3. Byron Joyner
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Correspondence to Byron Joyner .

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Editors and Affiliations

  1. School of Medicine, Harborview Medical Center, University of Washington, 1959 NE Pacific Street Box 356510, Seattle, 98195, Washington, USA

    Hunter Wessells

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Nguyen, H.T., Avery, D., Joyner, B. (2013). Posterior Urethral Valves. In: Wessells, H. (eds) Urological Emergencies. Current Clinical Urology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-62703-423-4_24

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  • DOI: https://doi.org/10.1007/978-1-62703-423-4_24

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