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Posterior Urethral Valves, Pediatric

Ryan W. Zipper, MD and Andrew A. Stec, MD Reviewed 10/2018
 


BASICS

DESCRIPTION

  • A posterior urethral valve (PUV) is an embryologic remnant of tissue in the urethra that causes obstruction of the lower urinary tract during fetal development.

  • This obstruction resul...

DIAGNOSIS

HISTORY

  • PUVs generally present in four ways:

    • Fetal diagnoses by ultrasound (US)

    • Neonates with respiratory distress, abdominal distension, metabolic abnormalities

    • Infants with a febrile urinary t...

TREATMENT

GENERAL MEASURES

Supportive 
  • Insertion of a urethral catheter or feeding tube in the neonate to bypass obstruction is the initial treatment.

  • Confirm placement of catheter in the bladder by US, ...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Careful follow-up through adulthood should be performed.

  • Pediatric urology follow-up is required for future reconstructive procedures and monitor...

ADDITIONAL READING

  • Chertin B, Cozzi D, Puri P. Long-term results of primary avulsion of posterior urethral valves using a Fogarty balloon catheter. J Urol.  2002;168(4, Pt 2):1841–1843. [View Abs...

CODES

ICD9

  • 753.8 Other specified anomalies of bladder and urethra

  • 753.6 Atresia and stenosis of urethra and bladder neck

  • 593.89 Other specified disorders of kidney and ureter

  • 591 Hydronephrosis

  • 593.70 Vesi...

FAQ

  • Q: Do patients with PUV have decreased fertility?

  • A: Limited studies suggest that children treated for PUV appear to have similar fertility rates as the general population. Rarely, investigation in...

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