POSTERIOR URETHRAL VALVE (PUV)

POSTERIOR URETHRAL VALVE (PUV)

Posterior urethral valve is a type of tissue fold seen in boys that blocks the bladder outlet. Since the urine in the bladder cannot come out sufficiently, this is reflected in the kidneys as high pressure. Vesico-ureteral reflux may be observed. The bladder wall thickens. The urinary tract expands (posterior urethra dilation). As urine output decreases in the womb, amniotic fluid (the water in which the child is in) also decreases. This poses a serious risk for the child.

Diagnosis can be made through antenatal ultrasound examinations (while the baby is in the womb). What needs to be done in children who are born prematurely or on time and can be kept alive is to cut this valve (tissue folds) as soon as possible with a closed method (endoscopic) and ensure normal bladder filling and emptying. These children who have difficulty urinating must first have a catheter installed. After the general condition is corrected, these valves are cut as soon as possible with closed, that is, endoscopic surgery. After these valves are cut, the child remains with a catheter for a while. It is observed that urination is better after the catheter is removed. These children need very long-term follow-up. Closed surgery may need to be repeated several times. If the diagnosis and treatment of this disease is delayed, the kidneys may lose their function and lead to chronic kidney disease. If swelling in the kidneys is seen in the ultrasonography performed in the womb; These children need to be followed up by a pediatric urologist or pediatric surgeon as soon as they are born.

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