MANAGEMENT OF POSTERIOR URETHRAL VALVES- A CLINICAL EXPERIENCE FROM INDIAN SETTINGS

Abstract

Objective: The present study aimed to highlight the current trends in the management of male patients with posterior urethral valves (PUV). Furthermore,thisstudy emphasized clinical, biochemical, and imaging patterns aswell as examined the outcomes of varioustreatment approachessuch as primary valve ablation and vesicostomy to manage PUV. Methods: This prospective clinical study was conducted in department of urology, Kurnool Medical College, Kurnool, AP. A total of 34 PU valve patients with mean age of 2.87 years with at least 6 months of follow-up were included in this study. Data related to demographic details, modes of presentation, diagnostic evaluation, presence of reux, renal status, treatment modalities and follow-up were collected. Surgical procedures included vesicostomy, and valve fulguration. Results: All the patients presented with obstructive voiding symptoms (100.00%), followed by fever with chills and rigors (67.60%) and pyuria (61.76%). Serum creatinine was normal in 13 patients and elevated in 21 patients. In all the cases PUV was diagnosed using MCUG. Overall, 12 (35.29%) patients presented with vesicoureteral reux prior to treatment. Bilateral and unilateral reux was noted in four and eight patients, respectively. Overall, 23 patients underwent primary valve fulguration and 11 patients underwent vesicostomy. In total 80% of patients maintained normal parameters at variable period of follow-up. Conclusion: The present study demonstrated favorable short-term results of primary valve ablation. However, vesicostomy was equally effective in patientswithbilateralhigh-grade reuxorsepsis despitevalve ablationand incircumstanceswhere there istechnicaldifcultyforvalve ablation.