Cystourethrography in Posterior Urethral Valves: Review of 20 Cases

Background: Posterior urethral valves (PUV) is a common cause of bladder outlet obstruction in the male infant; child or adolescent. Early diagnosis is important in order to prevent renal damage. Aim: To highlight delays in early diagnosis as a result of changing dressing habits-use of diapers in children.Methods: A retrospective review of 20 patients with posterior urethral valves seen by the author over a period of five years (1999-2003) at a private radiological diagnostic centre in Port Harcourt. Results: In the period under review; 208 patients had cystourethrography in the centre. Of these; 35(16) were paediatric patients. Twenty(57) of the paediatric patients had posterior urethral valves and all the patients were males. Majority of the patients (85) were seen in the first two years of life. All the patients presented with abdominal distension. Five of the patients whose mothers were primips were not able to describe the pattern of urine flow from the children as they always had diapers on. Diverticulum was seen in five patients (25) and these were aged one year and above.Conclusion: Posterior urethral valves is a common cause of bladder outlet obstruction in male children. Diverticulum; a complication of bladder outlet obstruction was common. Use of diapers and poor education may contribute to delays in diagnosis. Early diagnosis is important to prevent end-stage renal failure

Renal Duplex Collecting System in Port Harcourt: a Six-year Retrospective Review

Background: Duplicated collecting system (DCS) is a common congenital genitourinary anomaly which is usually detected on imaging studies performed for other reasons. It may be accompanied by various complications or associated with a variety of congenital genitourinary anomalies. Aim: To evaluate the incidence of duplication anomalies; the types of duplicated collecting systems; their complications and associated genitourinary congenital anomalies in Port Harcourt. Methods: This was a retrospective review of two thousand intravenous urogram (IVU) radiographs seen by the authors over a 6-year period; between 2000 and 2005 at Pix Centre; a private radiological centre in Port Harcourt; Nigeria. Results: Eighteen cases of DCS out of two thousand radiographs were seen in this period. Six (33.9) were males and 12 (66) were females. Sixteen (88.9) were unilateral and 2(11.1) were bilateral. Twelve (66.7) were on the right and 8(44.4) on the left. There was bifid pelvis in 1(5.6) and bifid ureters in 17(94.4). There was no complete duplicated collecting system. There was calyceal clubbing in 2(11). Ipsilateral ureterocele was noted in 1(5.6). The incidence of duplicated collecting system from our series was 0.9. Conclusion: Duplicated collecting system in our environment is relatively rare. The commonest type is of the bifid ureter (incomplete ureteral duplication). There is low rate of association with other serious congenital anomalies of the urogenital system. There is female preponderance with a female to male ratio of 2:1