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ORIGINAL ARTICLE
Year : 2018  |  Volume : 4  |  Issue : 1  |  Page : 29-33

The experience of managing Posterior Urethral Valve (PUV) over a period of 5 years: A single centre study at a tertiary care centre in Bihar


1 Department of Paediatric Surgery, Indira Gandhi Institute of Medical Sciences, Sheikhpura, Patna-14, Bihar, India
2 Department of General Surgery, Indira Gandhi Institute of Medical Sciences, Sheikhpura, Patna-14, Bihar, India

Correspondence Address:
Ramdhani Yadav
Assistant Professor, Pediatric Surgery, Indira Gandhi Institute of Medical Sciences, Sheikhpura, Patna-14, Bihar
India
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Source of Support: None, Conflict of Interest: None


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Objective: To evaluate the clinical presentation, management, complications, surgical management and long term outcome of Posterior urethral valve. Methods: A retrospective study was done on 203 patients of Posterior urethral valve treated in the Department of Paediatric surgery, Indira Gandhi Institute of Medical Sciences, Patna from January, 2011 to December, 2016. Data regarding clinical history, examination findings, investigation results and treatment given were collected from their case records. Data collected were analyzed. Results: A total of 203 patients with a mean age of 31.78 ± 9.11 months presented to the Paediatric surgery department with dribbling, poor urinary stream (55.17%) and urinary tract infection (36.94%) as the major symptoms. Ten patients had an antenatal diagnosis and twenty five patients presented early as neonates. Vesico-ureteric reflux was found in 55.66% cases. While 71.92% patients had cystoscopic fulguration, in 13.79% patients we had to use Chooramani Hook to ablate the valves and 14.29% patients had to be diverted to treat urosepsis. Residual valves were seen in 15.76% cases. Valve bladder syndrome occurred in 60.59% cases. There were seven deaths in the study. Mean follow-up in our series was 2.6 ± 1.1years. Conclusion: Urinary drainage by feeding tube in neonatal period, followed by cystoscopic valve ablation is the appropriate treatment in patients of PUV. Urinary diversion helps in cases of urosepsis which don’t settle on catheterization or valve ablation. Early diagnosis, early valve fulguration and management of Valve bladder syndrome have significant impact on outcome.


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