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Journal of Indian Association of Pediatric Surgeons
     Journal of Indian Association of Pediatric Surgeons
Official journal of the Indian Association of Pediatric Surgeons         
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Year : 2003  |  Volume : 8  |  Issue : 3  |  Page : 169-174

Posterior urethral valve : the current perspective

Dept. of Pediatric Urology Great Ormond Street Hospital for Children NHS Trust, London WC1 3JH

Correspondence Address:
PG Duffy
Dept. of Pediatric Urology Great Ormond Street Hospital for Children NHS Trust, London WC1 3JH

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Source of Support: None, Conflict of Interest: None

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ABSTRACT: The posterior urethral valve is the commonest cause of bladder outlet obstruction in children. With the improvement of primary health care system and due to the widespread use of ultrasonography during antenatal checkup the incidence of early diagnosis of posterior urethral valve has increased. The ultrasonography, estimation of blood biochemistry and micturating cystourethrography are the primary modes of investigation in the postnatal period. After an initial period of catheterization and vasodilatation by administration of fluid and electrolytes, endoscopic rsection of valve is the first choice of treatment. The technique of endoscopic valve resection has been standardized. The neonatal resectoscope (9F) cannot be used in many premature or small for date babies. Although major improvement has been made, further miniaturization of the neonatal resectoscope is the need of the day. Vesicostomy is the preferred form of temporary urinary diversion, without any long term morbidity. Supravesical diversion has limited but definite role. There are very few long term follow up studies of posterior urethral valve managed on a uniform protocol. Our knowledge about the pathophysiology of the patient with posterior urethral valves, ability to perform video urodynamics and apply it to plan the treatment has improved. The ongoing prospective studies will define the exact role of invasive urodynamics and the scope of secondary surgical intervention.

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  2005 - Journal of Indian Association of Pediatric Surgeons | Published by Wolters Kluwer - Medknow 

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