Experience of Posterior Urethral Valves with Vesicoureteral Reflux

Kim, Jong Kwon; Woo, Young Nam; Kim, Done Han

Abstract

A retrospective review was undertaken of 5 pediatric cases of posterior urethral valve with vesicoureteral reflux. The clinical data were summarized as follows : 1. At the time of diagnosis, patient age was recorded as 2 months, 3, 4, 13, and 14 years. Three cases presented with high fever, one with urinary dribbling and one with acute epididymitis. 2. Voiding cystourethrogram was abnormal in all cases, showing thickened, trabeculated bladder wall, dilatation of posterior urethra and vesicoureteral reflux. Vesicoureteral reflux was bilateral in 3 cases, unilateral in 2 cases and its degree was grade R-V/V in 8 renal units, grade E/V in one renal unit. 3. Initially transurethral valve ablation was performed in all cases, of which 2 had concomitant antireflux surgery and 3 had delayed ureteral reconstruction between one and 11 months after valve ablation. 4. Follow up duration was between 13 and 53months. In 4 cases, reflux disappeared and the pyelographic appearance markedly improved as regards pelvocalyceal and ureteral dilatation with improvement of general status at followup. But, in one case that had demonstrated bilateral high grade vesicoureteral reflux with sever ureteral dilatation and poor renal function, voiding symptom and radiologic appearance improved but left vesicoureteral reflux persisted by 13 months after reconstructive surgery.