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Congenital Anomalies of the Urethra

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Congenital Anomalies of the Kidney and Urinary Tract

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Abstract

Congenital anomalies of the urethra include posterior urethral valve (PUV), anterior urethral valves, urethral strictures, urethral duplication, urethral diverticula, urethral polyps, megalourethra, and urethral atresia. PUV represents the most common cause of congenital urethral obstruction by far. It should be suspected prenatally in all male fetuses with bilateral hydronephrosis and especially in those with a thick-walled bladder that is not seen to empty during ultrasound imaging. The diagnosis of PUV postnatally is made on the basis of findings on a voiding cystourethrogram (VCUG). Favorable prognostic indicators of PUV include nadir serum creatinine <0.8 mg% before age 1 year, absent vesicoureteral reflux (VUR), continence at the age of 5 years, and persistence of pop-off phenomenon. In this chapter, we will focus on PUV.

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Abbreviations

BNI:

Bladder neck incision

BNO:

Bladder neck obstruction

CIC:

Clean intermittent catheterization

CKD:

Chronic kidney disease

EBC:

Expected bladder capacity

ESRD:

End-stage renal disease

HUN:

Hydroureteronephrosis

LOC:

Loss of compliance

LUT:

Lower urinary tract

LUTO:

Lower urinary tract obstruction

NBE:

Nocturnal bladder emptying

PUV:

Posterior urethral valve

PVR:

Post-void residual

SNOB:

Syndrome of nocturnal overdistention of the bladder

VA:

Vesicoamniotic

VCUG:

Voiding cystourethrogram

VUDS:

Video urodynamic study

VUR:

Vesicoureteral reflux

VURD:

Vesicoureteral reflux dysplasia

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Authors and Affiliations

  1. Department of Urology, Columbia University Medical Center, New York, NY, USA

    Kenneth I. Glassberg M.D.

  2. Division of Urology, Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Jason P. Van Batavia M.D.

  3. Division of Urology, Weill Cornell Medical College, New York, NY, USA

    Andrew J. Combs P.A-.C.

  4. Department of Urology, Riley Hospital for Children, Indianapolis, IN, USA

    Rosalia Misseri M.D.

  5. Department of Urology, Indiana University School of Medicine, Indianapolis, IN, USA

    Rosalia Misseri M.D.

Authors
  1. Kenneth I. Glassberg M.D.
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  2. Jason P. Van Batavia M.D.
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  3. Andrew J. Combs P.A-.C.
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  4. Rosalia Misseri M.D.
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Corresponding author

Correspondence to Kenneth I. Glassberg M.D. .

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Editors and Affiliations

  1. Department of Pediatrics, Georgetown University Medical Center, Washington, District of Columbia, USA

    Amin J. Barakat

  2. Division of Pediatric Urology, Children’, George Washington University School of M, Washington, District of Columbia, USA

    H. Gil Rushton

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Glassberg, K.I., Van Batavia, J.P., Combs, A.J., Misseri, R. (2016). Congenital Anomalies of the Urethra. In: Barakat, A., Rushton, H. (eds) Congenital Anomalies of the Kidney and Urinary Tract. Springer, Cham. https://doi.org/10.1007/978-3-319-29219-9_7

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