The posterior urethral valve (PUV) can be defined as a membranous (membranous) formation originating from the posterior urethra that narrows and occludes the lumen, making voiding difficult. It is a urinary system anomaly that can be life-threatening by causing infravesical obstruction in prenatal or neonatal boys.
While the diagnosis of PUV was made with micturition (voiding) problems in the past, it has become possible to make antenatal diagnosis with the widespread use of prenatal ultrasonographic evaluation.
Mild forms are asymptomatic or have minimal micturition problems. PUV should be considered in the differential diagnosis if there is micturition difficulty, urinary incontinence due to incomplete emptying of the bladder, and urinary tract infection in an infant, child or adolescent. PUV diagnosis should be considered primarily in male fetuses with perforation and decrease in amniotic fluid. Obstruction is severe in PUVs detected by ultrasound in the antenatal period. In milder cases where the obstruction only causes micturition difficulty, diagnosis may be extended to late childhood or adolescence. In such cases, the findings on ultrasound may be more uncertain than in severe forms. Thickening of the bladder wall, presence of residual urine in the bladder after micturition, and enlargement of the collecting system of the kidneys depending on the degree of obstruction are the findings. In the patient with these findings on ultrasound, voiding cystourethrography (radiographic imaging performed during voiding by filling the bladder with contrast material) is required for diagnosis. In this examination, the diagnosis can be made by the wide and long prostatic urethra. In cases with faint radiographic findings, it is possible to confirm the diagnosis by the cystoscopic evaluation of the urethra (examination of the urinary duct and urinary bladder with a camera) by directly seeing the membranous structures causing the obstruction. This method also allows the therapeutic procedure to be performed if PUV is detected during cystoscopy. .
It should not be forgotten that patients are candidates for bladder dysfunction in the future. Patients with posterior urethral valves Patients should be followed up with the cooperation of pediatric nephrology and pediatric urology.
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