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Paediatric Urology
Published in Manit Arya, Taimur T. Shah, Jas S. Kalsi, Herman S. Fernando, Iqbal S. Shergill, Asif Muneer, Hashim U. Ahmed, MCQs for the FRCS(Urol) and Postgraduate Urology Examinations, 2020
Jemma Hale, Arash K. Taghizadeh
Posterior urethral valves occur as a congenital obstruction of the bladder outflow. All subsequent problems in a boy with posterior urethral valves follow from the obstruction that is present during the development of the bladder and upper tract. Other systems (e.g., cardiac or nervous) are not affected.
Renal Diseases
Published in Stephan Strobel, Lewis Spitz, Stephen D. Marks, Great Ormond Street Handbook of Paediatrics, 2019
All neonates with severe antenatal hydronephrosis should be commenced on prophylactic antibiotics pending definitive diagnosis. Posterior urethral valves should be resected and other associated defects treated. Management of primary VUR involves prompt diagnosis and management of febrile UTIs to prevent renal damage caused by recurrent pyelonephritis. There is controversy regarding the effectiveness of either medical (long-term antibiotic prophylaxis) or surgical interventions (antireflux surgery) in affected children.
Genito-Urinary Tract Anomalies
Published in Asim Kurjak, CRC Handbook of Ultrasound in Obstetrics and Gynecology, 2019
Sometimes, hydronephrosis may produce large cystic lesions where little of the original renal structure can be identified. In these instances, differentiation from multicystic kidney may be impossible. The finding of dilated minor calyces may suggest multicystic disease, but the prominent and dilated renal pelvis is the key in such cases. There may also be obstruction of the urethra, in the posterior urethral valves, for example. Posterior urethral valves (Potter type IV) affects male fetuses almost exclusively (Figure 6). Here, one finds megacystis with secondary hydro-urethra and hydronephrosis. The anomaly is potentially treatable in utero and, therefore, discussed in detail in Chapter 3, Volume II.
No single reason behind adult lower urinary tract symptoms in patients with posterior urethral valves
Published in Scandinavian Journal of Urology, 2019
Jenni Jalkanen, Jukka Heikkilä, Seppo Taskinen
We retrospectively reviewed the hospital database for patients with posterior urethral valves born between 1953 and 1999 and treated in the Helsinki University Children’s Hospital. We obtained an institutional review board approval before the study initiation. A Finnish translation of the validated DAN-PSS questionnaire was used to assess the occurrence and bother of 12 different LUTS—hesitancy, weak stream, incomplete emptying, straining, increased daytime frequency, nocturia, urinary urgency, urgency urinary incontinence, pain/burning, post-micturition dribble, stress urinary incontinence, and overflow/seeping incontinence [15]. The questionnaires were mailed to 108 patients in 2009, 68 of these patients responded, and their results were compared against a population of the same age and sex characteristics from our previous study [3]. Afterwards, the DAN-PSS questionnaire was included in our clinical follow-up protocol and we have further collected answers from 10 of 36 PUV patients, aged between 16 and 18 years, during their last control in our hospital. We evaluated the questionnaire results from all 78 patients, and compared the results with the patient history. Voiding and storing scores were calculated. In addition, the specific symptoms (incomplete emptying, straining, nocturia, and incontinence) more prevalent in the patients than in the controls in our previous study were evaluated in further detail. Uroflowmetry and post-voiding residual (PVR) measurements in young adulthood were available from 23 patients with a median age of 18 years (range = 16–29). In addition, urine excretion measurements taken over a period of 24 h were available from 24 patients at a median age of 24 years (range = 16–39).
Prenatal diagnosis and outcome of unilateral multicystic kidney
Published in Journal of Obstetrics and Gynaecology, 2021
Gurcan Turkyilmaz, Bilal Cetin, Emircan Erturk, Tugba Sivrikoz, Ibrahim Kalelioglu, Recep Has, Atıl Yuksel, Tayfun Oktar, Orhan Ziylan
Although appropriate prenatal counselling is the most critical process of prenatal diagnosis, there is limited available evidence on parents' experiences of counselling for congenital anomalies. Marokakis et al. (2017) evaluated 17 parents with nine MCDK and eight posterior urethral valves (PUV) foetuses. They showed that parents described shock, fear and uncertainty after diagnosis, but they were satisfied with the information received. In our clinic, we counselled the families with a paediatric urologist and gave them brochures about MCDK.
Fetal Megacystis: Associated Structural Abnormalities and Obstetric Outcomes
Published in Fetal and Pediatric Pathology, 2023
Manuel Sánchez-Prieto, Laura Perdomo, Berta Cortés, Ignacio Rodríguez, Pilar Prats, Alberto Rodríguez-Melcón, Pere Barri-Soldevila, Bernat Serra, Gerard Albaigés
Ultrasound plays an important role in the characterization of FM. It allows us to distinguish between various etiologies, like posterior urethral valves, prune belly syndrome, urethral atresia, or megacystis-microcolon-intestinal hypoperistalsis syndrome [3,7]. Posterior urethral valves refer to a male-exclusive congenital anomaly characterized by a membrane in the posterior portion of the urethra resulting from fusion or prominence of the plicae colliculi in the verumontaneous region that can lead to varying degrees of urinary obstruction [3,7].