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| Year : 2003 | Volume
: 8
| Issue : 3 | Page : 133-139 |
The experience of managing posterior urethral value (PUV) over a period of 22 years : a single center study
AN Gangopadhaya
Dept. of Pediatric Surgery Institute of Medical Sciences Banaras Hindu University Varanasi-221005, India
Correspondence Address:
AN Gangopadhaya
Dept. of Pediatric Surgery Institute of Medical Sciences Banaras Hindu University Varanasi-221005
India
 Source of Support: None, Conflict of Interest: None  | Check |
ABSTRACT: The mortality of posterior urethral valve (PUV) has dropped in the recent past because of its early diagnosis and better medical and surgical care. The incidence of PUV in our study was 3.5 per 1000 Pediatric Surgical OPD cases. Nearly half (47.68 percent) presented in the first three months of life and 75 percent presented with urinary symptoms. Inspite of various non invasive procedures, the voiding cystourethrogram (VCU) still stands out as the most important investigation for deciding the course of action. Primary valve ablation should be tried in al cases before embarking upon diversion. In our series, loop cutaneous ureterostomy was found to have better results than cutaneous vesicostomy. For long-term follow up, serial estimation of serum creatinine and examination of urine for pus cells are the two most simple, yet effective tests for assessing the prognosis. DMSA/DTPA renal scan and urodynamic studies are required in problematic cases only. Out of 516 cases assessed for long term follow up (5-20 years), only 312 (60.5 percent) are coning for regular follow up and 52 percent are leading normal life with normal renal parameters. Out the these 312 cases, only 48 percent have attained 80th percentile of height and 70th percentile of weight and the rest are below 50th percentile in term of height and weight as compared to normal age matched control group.
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