Posterior urethral valves
From Wikipedia, the free encyclopedia
| Posterior urethral valves Classification and external resources |
|
| DiseasesDB | 34137 |
|---|---|
| eMedicine | ped/2357 radio/572 |
Posterior urethral valves are an obstructive congenital defect of the male urethra.[1]
Contents |
[edit] Classification
Posterior urethral obstruction was first classified by Hugh Hampton Young, urology pioneer, in 1919. More recent evidence suggests that obstruction in the posterior urethra is a COPUM (Congenital Obstructive Posterior Urethral Membrane), while the fibrous obstructive anomalies in the more distal urethra are remnants of the urogenital membrane, also called Cobb's Collar. These are equivalent to Young's type III lesions, which are not in the posterior urethra.
[edit] Diagnosis
- Abdominal ultrasound is of some benefit, but not diagnostic. Features that suggest posterior urethral valves are:
- Bilateral hydronephrosis.
- Thickened bladder wall
- Bladder diverticula
- Voiding cystourethrogram (VCUG) - diagnostic
[edit] Complications
[edit] Treatment
There are three treatments of the posterior urethral valves:
- Vesicostomy and then valve ablation - making a stoma (a hole) in the urinary bladder, also known as high diversion, followed by closure of the stoma and valve abalation.
- Pyelostomy and then valve ablation - making a stoma (a hole) in the pelvis of the kidney, also known as high diversion, followed by closure of the stoma and valve abalation.
- Primary (transurethral) Valve ablation - removal of the valves through urethra, without stoma.
The standard treatment is primary (transurethral) ablation of the valves.[2] Urinary diversion is used in selected cases,[2] and its benefit is disputed.[3][4]
[edit] Female homolog
The female homolog to the male verumontanum from which the valves originate is the hymen.
[edit] References
- ^ Manzoni C, Valentini A. "Posterior urethral valves.". Rays 27 (2): 131–4. PMID 12696266.
- ^ a b Warren J, Pike JG, Leonard MP. Posterior urethral valves in Eastern Ontario - a 30 year perspective. Can J Urol. 2004 Apr;11(2):2210-5. PMID 15182412.
- ^ Kim YH, Horowitz M, Combs A, Nitti VW, Libretti D, Glassberg KI. Comparative urodynamic findings after primary valve ablation, vesicostomy or proximal diversion. J Urol. 1996 Aug;156(2 Pt 2):673-6. PMID 8683757.
- ^ Smith GH, Canning DA, Schulman SL, Snyder HM 3rd, Duckett JW. The long-term outcome of posterior urethral valves treated with primary valve ablation and observation. J Urol. 1996 May;155(5):1730-4. PMID 8627873.
 |
This medical article is a stub. You can help Wikipedia by expanding it. |
