Posterior urethral valve: a retrospective review of cases and challenges of management in a low-resource centre

Abstract

Objective: Posterior urethral valves (PUV) diagnosis and management remain a major challenge in developing countries. We sought to review cases of PUV managed in our health centre and to highlight the challenges in its management.Methods: A retrospective analysis of patients with PUV managed over a 12month period. Data obtained from patients' medical records include: demography, clinical presentation, serum electrolytes, urea and creatinine, radiological diagnosis, initial management, surgical management and the outcome of management.Results: Eight patients were managed during the period under review. The median age was 26 months. The commonest clinical feature was recurrent fever. Three patients (37.5%) had renal insufficiency requiring peritoneal dialysis at initial presentation. Six patients (75%) had Mohan's valvotomy while two (25%) died before valve ablation. One patient (12.5%) died a month after valve ablation from renal failure, while one (12.5%) had residual valve requiring a repeat valve ablation. Post-operative complication of urosepsis occurred in two patients (25%).Conclusions: Physicians should have a high index of suspicion for PUV in boys who present with recurrent fever or urinary tract infections. Screening for foetal anomalies during routine ante-natal maternal ultrasonography will improve prenatal diagnosis of this condition.Keywords: Low-resource centre, Management, Nigeria, Posterior urethral valve