Posterior urethral valve Flashcards
(11 cards)
What is a posterior urethral valve?
A condition where there is tissue at the proximal end of the urethra that causes obstruction of urine output. It occurs in newborn boys and leads to back pressure into the bladder, ureters, and kidneys, causing hydronephrosis.
What complications arise from a posterior urethral valve?
The obstruction prevents the bladder from fully emptying, leading to a reservoir of urine that increases the risk of urinary tract infections
What are the presentations of a posterior urethral valve?
- can vary in severity
- mild cases can be asymptomatic
- difficulty urinating
- weak urinary system
- chronic urinary retention
- palpable bladder
- recurrent UTIs
- impaired kidney function
What can severe cases of posterior urethral valve lead to?
Severe cases can cause obstruction to urine outflow in the developing fetus, leading to bilateral hydronephrosis and oligohydramnios, which can result in pulmonary hypoplasia (underdeveloped fetal lungs) and respiratory failure shortly after birth.
How are severe cases of posterior urethral valve investigated?
Severe cases may be detected on antenatal scans as oligohydramnios and hydronephrosis. Post-birth investigations include: abdominal ultrasound, micturating cystourethrogram (MCUH), and cystoscopy.
What does an abdominal ultrasound show in cases of posterior urethral valve?
It may show an enlarged, thickened bladder and bilateral hydronephrosis.
What does a micturating cystourethrogram (MCUH) reveal?
It shows the location of the extra urethral tissue and reflux of urine back into the bladder.
What is the purpose of cystoscopy in managing posterior urethral valve?
Cystoscopy involves inserting a camera into the urethra to view the extra tissue and can also be used to ablate or remove the extra tissue.
What is the management for mild cases of posterior urethral valve?
Mild cases can be observed and monitored.
What can be done for moderate cases of posterior urethral valve/whilst awaiting definitive treatment?
A temporary urinary catheter can be inserted to bypass the valve while awaiting definitive management.
What is the definitive management for posterior urethral valve?
Definitive management is by ablation or removal of the extra urethral tissue, usually during cystoscopy.
