Volume 2, Issue 2, December 2018, Page: 25-29
Challenges in the Management and Outcome of Posterior Urethral Valve in Aba, Nigeria
Ekpemo Samuel Chidi, Department of Surgery, Abia State University, Aba, Nigeria
Okoronkwo Nneka, Department of Paediatrics, Abia State University, Aba, Nigeria
Eleweke Ndubuisi, Department of Surgery, Abia State University, Aba, Nigeria
Eweputanna Lisa, Department of Radiology, Abia State University, Aba, Nigeria
Received: Aug. 21, 2018;       Accepted: Sep. 19, 2018;       Published: Oct. 10, 2018
DOI: 10.11648/j.ijcu.20180202.11      View  206      Downloads  11
Posterior urethral valves are the commonest cause of bladder outlet obstruction in boys. The incidence varies from 1 in 5000 to 25,000 live birth worldwide. The incidence in lower and middle- income countries is unknown due to paucity of data. . The aim of this study was to review the presentation, management and outcome of posterior urethral valve at the Abia State University Teaching Hospital Aba, Nigeria. Patients and Methods: Fifteen boys with posterior urethral valve seen at the Abia State University Teaching Hospital Aba from January 2016 to June 2018 were included in the study. Data collected includes demographic data, clinical features, and duration of symptoms, serum biochemistry, radiological diagnosis, surgical management and outcome. Results: The patient age ranged from 2 weeks to 2 years, Median age of 6 months. 7(46.6%) of the patients were neonates. The commonest symptoms were voiding dysfunction, distended bladder and anaemia. Duration of symptoms was 2weeks in 6 (40%) patients, 4 weeks in 4(27) patients and 8weeks in 5(33%) patients. 2(13%) patients had grade 2 vesicoureteric reflux on expressive cystourethrogram. All the patients had foley catheter avulsion of posterior urethral valve. There was no case of frank haemorrhage but haematuria was noticed which resolved spontaneously. Fourteen (93.3%) out of 15 patients reported consistent good urinary stream without evidence of renal deterioration. A patient (6.6%) had persistent straining at micturition requiring a repeat Foley catheter balloon avulsion. All mothers were satisfied with the outcome of treatment due to good post- operative urinary stream. There was complete resolution of the vesicoureteric reflux at 6 months post valve ablation expressive cystourethrogram. The post -operative urinary stream, serum electrolyte, and urea and cretinine status remained normal during follow up period of 6 months. Conclusion: Posterior urethral valve is a common cause of bladder outlet obstruction in boys, high index of suspicion will lead to early diagnosis, late presentation still persist due to poor knowledge of health care workers in our environment.
Posterior Urethral Valve, Challenges, Management, Outcome
To cite this article
Ekpemo Samuel Chidi, Okoronkwo Nneka, Eleweke Ndubuisi, Eweputanna Lisa, Challenges in the Management and Outcome of Posterior Urethral Valve in Aba, Nigeria, International Journal of Clinical Urology. Vol. 2, No. 2, 2018, pp. 25-29. doi: 10.11648/j.ijcu.20180202.11
Copyright © 2018 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Tambo FM, Tolafec PN, Mikande JZ. Posterior urethral valves: 10years audit of epidemiologic, diagnostic and therapeutic aspects in Yaoundé Gynaeco-Obstetric and Paediatric hospital.BMC Urology 2018 18:46.
Krishnan, A., de Souza, A., Konijeti, R., and Baskin, L.S. The anatomy and embryology of posterior urethral valves. J. Urol. 2006; 175, 1214–1220.
Jaja T, Anochie IC, Eke FU. Posterior urethral valve in childhood in Port Harcourt, Nigeria. Port Harcourt Med J 2012;6:10‑6.
Uba AF, Chirdan LB, Ihezue CH, Ramyil VL, Dakum NK. Posterior urethral valves in childhood: Experience in a centre with scarce facilities. Afr J Urol 2007;13:124‑31.
Angwafo F, Andze G, Biouele JM, Sosso MA, Edzoa T, Niat G. Les valves de l’urètre postérieur chez l’enfant : à propos de 22 cas. J Urol. 1995; 101(3):132–7. 14.
Chiabi A, Angwafo F, Obama MT, Takou V, Zoung JK. Posterior urethral valves in children: a review of 28 cases in Yaounde, Cameroon. Clin Mother Child Heal. 2006;1(2).
Talabi AO, Sowande OA, Etonyeaku AC, Salako AA, Adejuyigbe O. Posterior urethral valves in children: Pattern of presentation and outcome of initial treatment in Ile-Ife, Nigeria. Niger J Surg 2015; 21:151-6.
Orumuah AJ, Oduagbon OE. Presentation, management, and outcome of posterior urethral valves in a Nigerian tertiary hospital. Afr J Paediatr Surg 2015; 12:18-22.
Odetunde OI, Odetunde OA, Ademuyiwa AO, Okafor HU, Ekwochi U, Azubuike JC, et al. Outcome of late presentation of posterior urethral valves in a resource‑limited economy: Challenges in management. Int J Nephrol 2012;:345298.
Nasir AA, Ameh EA, Abdur‑Rahman LO, Adeniran JO, Abraham MK. Posterior urethral valve. World J Pediatr 2011;7:205‑16.
Okafor HU, Ekenze SO, Uwaezuoke SN. Posterior urethral valves: Determinants of outcome in a developing country. J Paediatr Child Health 2013;49:115‑9.
Ohagwu CC, Abu PO, Odo MC, Chiegwu HU. Maternal perception of barriers to utilization of prenatal ultrasound in prenatal care in the northern part of Nigeria. Clin Mother Child Health 2010;7:1195‑9.
Sudarsanan B, Nasir AA, Puzhankara R, Kedari PM, Unnithan GR, Damisetti KR. Posterior urethral valves: A single center experience over 7 years. Pediatr Surg Int 2009;25:283‑7.
Shittu OB, Asinobi AO. Long‑term outcome of posterior urethral valves ablation using the Mohan’s urethral valvotome. West Afr J Med 2004;23:35‑7.
Uwaezuoke SN, Echetabu KN. Obstructive Uropathy Secondary to Posterior Urethral Valves: Retarding the Progression to End-Stage Kidney Disease in Children. J Urol Nephrol. 2015; 2(2): 4.
Hodges, S.J., Patel, B., McLorie, G., and Atala, A. Posterior urethral valves. TSW Urology (2009) 9, 1119–1126.
Bhaumik K, Chatterjee I, Basu KS, Samanta N, Das S. Posterior urethral valve : its clinical, biochemical and imaging patterns. J Indian Assoc Pediatr Surg. 2003; 8(3):153.
Mirshemirani A, Khaleghnejad A, Rouzrokh M, Sadeghi A, Mohajerzadeh L, Sharifian M. Posterior urethral valves; a single center experience. Iran J Pediatr. 2013; 23(5):531–5.
Sudarsanan B, Nasir AA, Puzhankara R, Kedari PM, Unnithan GR, Damisetti KRP. Posterior urethral valves: a single center experience over 7 years. Pediatr Surg Int. 2009; 25(3):283–7.
.Van Den Bulcke C, Hennebert PN. Observations on the effect of lower urinary tract obstruction. A report on urethral valvular obstruction in 17 Central African children. Br J Urol 1967;39:762‑7.
Shirazi M, Farsiani M, Natami M, Izadpanah K, Malekahmadi A, Khakbaz A. Which patients are at higher risk for residual valves after posterior urethral valve ablation? Korean J Urol 2014;55:64‑8.
Close, C.E., Carr, M.C., Burns, M.W., and Mitchell, M.E. Lower urinary tract changes after early valve ablation in neonates and infants: is early diversion warranted? J. Urol.1997 157, 984–988.
Peters, C.A., Bolkier, M., Bauer, S.B., Hendren, W.H., Colodny, A.H., Mandell, J., and Retik, A.B. The urodynamic consequences of posterior urethral valves. J. Urol. 1990144, 122–126.
Browse journals by subject