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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 : 148-152

Clinical spectrum of posterior urethral valve obstruction in children


Department of Pediatric Surgery Kalawati Saran Children's Hospital, Lady Hardinge Medical College, New Delhi-110001

Correspondence Address:
SR Choudhury
Department of Pediatric Surgery Kalawati Saran Children's Hospital, Lady Hardinge Medical College, New Delhi-110001

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Source of Support: None, Conflict of Interest: None


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ABSTRACT: Children with posterior urethral valve (PUV) obstruction constitute a significant number of hospital admissions in our Pediatric Surgery Unit. We present a single institution experience in the management of children with PUV. Over the past three years (2000-2002) 90 patients with PUV were treated in our hospital. Majority of them presented in the first year of life. Seventy one percent (64/90) had renal failure at presentation. Voiding cystourethrography (VCUG) was the mainstay of the diagnosis. Associated vesicoureteric reflux (VUR was present in (51/90) 56 percent of cases, and was mostly unilateral (90percent). After initial per urethral catheter drainage, 75 percent showed an improvement in the renal function. Primary urethral fulguration of valve was done mostly in older children whereas neonates and non-responders to catheter drainage underwent vesicostomy. The high incidence of diversion in our series was due to non-availability of adequate size resectoscope. Short-term follow up showed adequate growth and nutrition in children on vesicostomy with recovery of renal function. However, a significant number of renal units (90 percent unilateral and 10 percent bilateral) showed poor function with functional obstruction in DTPA scan. This report highlights the treatment protocol and problems faced in the management of children with PUV in a Paediatric Surgical Unit of a medical college hospital set-up.






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

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