Outcome of Prenatally Diagnosed Posterior Urethral Valve Patients - Experience from a Low Income Country

  • Mahfuzul Kabir Department of Pediatric Surgery, Chittagong Medical College Hospital, Chittagong
  • Musarrat Naz Department of Gynecology and Obstetrics, Chittagong Medical College Hospital, Chittagong
  • Md Abdullah Al Farooq Department of Pediatric Surgery, Chittagong Medical College Hospital, Chittagong
  • Tanvir Kabir Chowdhury Department of Pediatric Surgery, Chittagong Medical College Hospital, Chittagong
  • Md Zonaid Chowdhury Department of Pediatric Surgery, Chittagong Medical College Hospital, Chittagong
  • Tahmina Banu Department of Pediatric Surgery, Chittagong Medical College Hospital, Chittagong
Keywords: posterior urethral valve, prenatal diagnosis, renal failure, low income country

Abstract

Purpose: To evaluate the outcome of prenatally diagnosed posterior urethral valve  (PUV) patients in our setup where fetal interventions are not available.

Methods: This prospective study included 24 PUV patients (July 2007 to December 2012), who  were diagnosed prenatally but had no prenatal interventions and delivered in our center.  Within 24 hours after birth, all of them had urinary ultrasonography (USG). Voiding  cystourethrography (VCUG) and renogram were done in the second week and  cystoscopy with valve ablation during the same admission period. Patients were  followed up regularly after cystoscopic fulguration. Clinical features, treatment, and  outcomes were analyzed.

Results: Predominant clinical features were renal failure  and urinary ascites. Eleven patients (45.8%) had bilateral vesicoureteric reflux  (VUR) of different grades. Eight patients (33.3%) had decreased renal cortical  thickness (<10 mm). All patients underwent cystoscopic fulguration except three  (expired before fulguration). Four patients (16.6%) needed cutaneous vesicostomy  along with fulguration. Follow up period ranged from 3 months to 6 years. At last  follow-up, 9 (37.5%) boys had renal failure; 7 patients (29%) had normal renal  parameters with good urinary stream. Mortality was 7 (29%) including 3 who died  before fulguration.

Conclusion: Prenatally detected PUV children seem to have  both morphologically and functionally compromised urinary system with poor  outcome.

DOI: http://dx.doi.org/10.11593/bje.2013.0103.0022

Bangladesh Journal of Endosurgery Vol.1(3) September 2013: 20-23

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Abstract
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Published
2014-01-09
How to Cite
Kabir, M., Naz, M., Farooq, M. A., Chowdhury, T., Chowdhury, M. Z., & Banu, T. (2014). Outcome of Prenatally Diagnosed Posterior Urethral Valve Patients - Experience from a Low Income Country. Bangladesh Journal of Endosurgery, 1(3), 20-23. Retrieved from https://www.banglajol.info/index.php/BJE/article/view/17597
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Original Articles