Posterior urethral valves in childhoos: experience in a center with scarce facilities

ABSTRACT

Posterior urethral valves [PUV] are the most common congenital causes of lower urinary tract obstruction in male children, but few cases have been reported from Nigeria. In this study we describe our 7-year experience of management of PUV in children in order to increase the awareness of this condition in our environment. This is a report of 41 consecutive children with PUV who were managed at the Jos University Teaching Hospitals [JUTH], Jos, Nigeria, from June 2000 to April 2006. Their age at presentation ranged from 2 days to 15 years [mean 2.5 years]. The relevant clinical, laboratory and radiological data were entered into a database and analyzed. Twenty-eight patients presented with a condition highly suspicious of PUV, while 7 patients presented with other urological conditions. Six patients presented with non-urological symptoms which caused a delay in diagnosis and institution of treatment. Voiding cystourethrography was diagnostic in all cases. In the majority of patients [n=31], management consisted of transurethral balloon avulsion of the valves yielding a satisfactory outcome in over 80% of the patients. Urethral stricture was the main complication [which responded to serial dilatation] and occurred in 3 patients. The postoperative mortality rate was 2.6%. Although this study was restricted to one hospital, there appears to be a high incidence of PUV in children in North Central Nigeria. An increased awareness of varied clinical features, a high index of suspicion and simple conservative treatment by balloon avulsion of PUV would improve the outcome: