Treatment Of Posterior Urethral Valves Research Articles

The Whitaker hook in the treatment of posterior urethral valves: S. Chandna, J. Bruce, A. Dickson, et al. Br J Urol 78:783–785, (November), 1996

The Whitaker hook in the treatment of posterior urethral valves: S. Chandna, J. Bruce, A. Dickson, et al. Br J Urol 78:783–785, (November), 1996

Valves de l'urètre postérieur: facteurs déterminant les résultats à long terme

Posterior urethral valves (PUV) is the most common congenital urine flow impairment in boys. Long-term prognosis involves: • -renal function impaired in 30 to 50% of PUV and leading to hyperdiuresis, low GFR and avidosis; • -bladder urodynamics impaired in 75% of PUV with abnormal urine storage, abnormal micturition and vesicoureteric reflux. Incontinence and recurrent urinary tract infections commonly reflect bladder and renal failures: • -abnormal bladder outle icuds to incontinence and abnormal ejaculation. The roles of antenatal treatments (vesico-ammotic shunts), neonatal treatments (ressuscitation and endoscopic treatment of PUV) and long-term treatments (urinary diversions, bladder augmentation, alpha blockers, anticholinergic, dialysis and renal transplant) in the long-term outcomes of PUV are reviewed.

The Whitaker hook in the treatment of posterior urethral valves.

To assess the efficacy of the Whitaker diathermy hook in the treatment of posterior urethral valves (PUV). Seventeen patients with PUV underwent primary treatment under general anaesthesia using a diathermy hook. The results were assessed by the clinical course of the patient, serial measurements of serum creatinine level and repeat cystography 6 weeks and 6 months after treatment. There were no complications in 12 patients and they required no further treatment of the valves. Three patients required a repeat procedure which resolved the urethral obstruction. Two patients continued to show incomplete disruption of the valves and required endoscopic treatment. Two patients developed ureteric obstruction after disruption of the valves, which was treated by supravesical diversion and later reversed with no further treatment of the valves. The Whitaker diathermy hook is a safe and effective instrument which has not gained its rightful place in the treatment of patients with PUV.

Urethral Valve Incision Using A Modified Venous Valvulotome

Anterior and posterior urethral valves have been treated with a variety of methods. The gold standard for treatment of posterior urethral valves is direct vision transurethral fulguration with the patient under general anesthesia. We report a bi-institutional experience using an adapted venous valvulotome to incise the obstructing valve leaflets. During the last 4 years 15 patients were treated, 4 with anterior and 11 with posterior urethral valves. There were no complications associated with this technique, and we believe that this is a safe and simple treatment option.

Laser treatment of posterior urethral valves in neonates.

The posterior valves of 13 neonates were resected using the neodymium:YAG laser in retrograde transurethral endoscopy. There were no strictures or other complications.

Congenital posterior urethral valves in an adult

An adult male with posterior urethral valves who had obstructive urinary symptoms and painless gross hematuria is presented. The diagnosis, development, and treatment of posterior urethral valves is discussed. The importance of also treating the hypertrophied bladder neck is stressed.