Posterior Urethral Valves (PUV)

Posterior urethral valves (PUV) are obstructive membranes that develop in the urethra close to the bladder. The valve can obstruct or block the outflow of urine through the urethra. When this occurs, the bladder, ureters and kidneys become progressively dilated depending on the level of blockage.

PUV are thought to develop in the early stages of fetal development. The abnormality affects only male infants and occurs in about 1 in 8,000 births. component.

PUV occur in varying degrees from mild to severe. Due to increased use of antenatal imaging, PUV may be identified before any symptoms are present and continuous monitoring throughout the pregnancy and after birth is done.

Children who are diagnosed later may have the following signs or symptoms that require treatment:

• Weak urine stream
• Difficulty with urination
• Urinary tract infection
• Urinary frequency

 Voiding cystourethrogram (VCUG) is done to diagnose PUV and to diagnose vesicoureteral reflux (VUR). Additional pictures are taken while child is urinating. The radiologist will look at the urethra while urine is passing to identify the blockage (PUV).

Ultrasonography

This procedure uses sound waves to outline the kidneys and bladder. It will enable us to see the degree of hydronephrosis and the shape of the bladder.

Blood tests

to check how well the kidneys are functioning.

Surgical treatment

Treatment for PUV depends on the severity of the condition, your child’s age, bladder and kidney status. The surgical goal is to preserve kidney and bladder function.

• Valve ablation: Once PUV are identified, they need to be surgically incised i'e valve ablation by cystoscope.
• Vesicostomy: In a situation where your baby is too small to undergo valve ablation or when a severe obstruction is noted, a vesicostomy may be recommended.
• Vesicostomy  is temporary option and can be closed in the future.

After successful bladder drainage,monitor child's condition throughout his childhood and adolescence.