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Challenges in the Management and Outcome of Posterior Urethral Valve in Aba, Nigeria

Received: 21 August 2018    Accepted: 19 September 2018    Published: 10 October 2018
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Abstract

Posterior urethral valves are the commonest cause of bladder outlet obstruction in boys. The incidence varies from 1 in 5000 to 25,000 live birth worldwide. The incidence in lower and middle- income countries is unknown due to paucity of data. . The aim of this study was to review the presentation, management and outcome of posterior urethral valve at the Abia State University Teaching Hospital Aba, Nigeria. Patients and Methods: Fifteen boys with posterior urethral valve seen at the Abia State University Teaching Hospital Aba from January 2016 to June 2018 were included in the study. Data collected includes demographic data, clinical features, and duration of symptoms, serum biochemistry, radiological diagnosis, surgical management and outcome. Results: The patient age ranged from 2 weeks to 2 years, Median age of 6 months. 7(46.6%) of the patients were neonates. The commonest symptoms were voiding dysfunction, distended bladder and anaemia. Duration of symptoms was 2weeks in 6 (40%) patients, 4 weeks in 4(27) patients and 8weeks in 5(33%) patients. 2(13%) patients had grade 2 vesicoureteric reflux on expressive cystourethrogram. All the patients had foley catheter avulsion of posterior urethral valve. There was no case of frank haemorrhage but haematuria was noticed which resolved spontaneously. Fourteen (93.3%) out of 15 patients reported consistent good urinary stream without evidence of renal deterioration. A patient (6.6%) had persistent straining at micturition requiring a repeat Foley catheter balloon avulsion. All mothers were satisfied with the outcome of treatment due to good post- operative urinary stream. There was complete resolution of the vesicoureteric reflux at 6 months post valve ablation expressive cystourethrogram. The post -operative urinary stream, serum electrolyte, and urea and cretinine status remained normal during follow up period of 6 months. Conclusion: Posterior urethral valve is a common cause of bladder outlet obstruction in boys, high index of suspicion will lead to early diagnosis, late presentation still persist due to poor knowledge of health care workers in our environment.

Published in International Journal of Clinical Urology (Volume 2, Issue 2)
DOI 10.11648/j.ijcu.20180202.11
Page(s) 25-29
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This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Posterior Urethral Valve, Challenges, Management, Outcome

References
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[2] Krishnan, A., de Souza, A., Konijeti, R., and Baskin, L.S. The anatomy and embryology of posterior urethral valves. J. Urol. 2006; 175, 1214–1220.
[3] Jaja T, Anochie IC, Eke FU. Posterior urethral valve in childhood in Port Harcourt, Nigeria. Port Harcourt Med J 2012;6:10‑6.
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[7] Talabi AO, Sowande OA, Etonyeaku AC, Salako AA, Adejuyigbe O. Posterior urethral valves in children: Pattern of presentation and outcome of initial treatment in Ile-Ife, Nigeria. Niger J Surg 2015; 21:151-6.
[8] Orumuah AJ, Oduagbon OE. Presentation, management, and outcome of posterior urethral valves in a Nigerian tertiary hospital. Afr J Paediatr Surg 2015; 12:18-22.
[9] Odetunde OI, Odetunde OA, Ademuyiwa AO, Okafor HU, Ekwochi U, Azubuike JC, et al. Outcome of late presentation of posterior urethral valves in a resource‑limited economy: Challenges in management. Int J Nephrol 2012;:345298.
[10] Nasir AA, Ameh EA, Abdur‑Rahman LO, Adeniran JO, Abraham MK. Posterior urethral valve. World J Pediatr 2011;7:205‑16.
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  • APA Style

    Ekpemo Samuel Chidi, Okoronkwo Nneka, Eleweke Ndubuisi, Eweputanna Lisa. (2018). Challenges in the Management and Outcome of Posterior Urethral Valve in Aba, Nigeria. International Journal of Clinical Urology, 2(2), 25-29. https://doi.org/10.11648/j.ijcu.20180202.11

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    ACS Style

    Ekpemo Samuel Chidi; Okoronkwo Nneka; Eleweke Ndubuisi; Eweputanna Lisa. Challenges in the Management and Outcome of Posterior Urethral Valve in Aba, Nigeria. Int. J. Clin. Urol. 2018, 2(2), 25-29. doi: 10.11648/j.ijcu.20180202.11

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    AMA Style

    Ekpemo Samuel Chidi, Okoronkwo Nneka, Eleweke Ndubuisi, Eweputanna Lisa. Challenges in the Management and Outcome of Posterior Urethral Valve in Aba, Nigeria. Int J Clin Urol. 2018;2(2):25-29. doi: 10.11648/j.ijcu.20180202.11

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  • @article{10.11648/j.ijcu.20180202.11,
      author = {Ekpemo Samuel Chidi and Okoronkwo Nneka and Eleweke Ndubuisi and Eweputanna Lisa},
      title = {Challenges in the Management and Outcome of Posterior Urethral Valve in Aba, Nigeria},
      journal = {International Journal of Clinical Urology},
      volume = {2},
      number = {2},
      pages = {25-29},
      doi = {10.11648/j.ijcu.20180202.11},
      url = {https://doi.org/10.11648/j.ijcu.20180202.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcu.20180202.11},
      abstract = {Posterior urethral valves are the commonest cause of bladder outlet obstruction in boys. The incidence varies from 1 in 5000 to 25,000 live birth worldwide. The incidence in lower and middle- income countries is unknown due to paucity of data. . The aim of this study was to review the presentation, management and outcome of posterior urethral valve at the Abia State University Teaching Hospital Aba, Nigeria. Patients and Methods: Fifteen boys with posterior urethral valve seen at the Abia State University Teaching Hospital Aba from January 2016 to June 2018 were included in the study. Data collected includes demographic data, clinical features, and duration of symptoms, serum biochemistry, radiological diagnosis, surgical management and outcome. Results: The patient age ranged from 2 weeks to 2 years, Median age of 6 months. 7(46.6%) of the patients were neonates. The commonest symptoms were voiding dysfunction, distended bladder and anaemia. Duration of symptoms was 2weeks in 6 (40%) patients, 4 weeks in 4(27) patients and 8weeks in 5(33%) patients. 2(13%) patients had grade 2 vesicoureteric reflux on expressive cystourethrogram. All the patients had foley catheter avulsion of posterior urethral valve. There was no case of frank haemorrhage but haematuria was noticed which resolved spontaneously. Fourteen (93.3%) out of 15 patients reported consistent good urinary stream without evidence of renal deterioration. A patient (6.6%) had persistent straining at micturition requiring a repeat Foley catheter balloon avulsion. All mothers were satisfied with the outcome of treatment due to good post- operative urinary stream. There was complete resolution of the vesicoureteric reflux at 6 months post valve ablation expressive cystourethrogram. The post -operative urinary stream, serum electrolyte, and urea and cretinine status remained normal during follow up period of 6 months. Conclusion: Posterior urethral valve is a common cause of bladder outlet obstruction in boys, high index of suspicion will lead to early diagnosis, late presentation still persist due to poor knowledge of health care workers in our environment.},
     year = {2018}
    }
    

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  • TY  - JOUR
    T1  - Challenges in the Management and Outcome of Posterior Urethral Valve in Aba, Nigeria
    AU  - Ekpemo Samuel Chidi
    AU  - Okoronkwo Nneka
    AU  - Eleweke Ndubuisi
    AU  - Eweputanna Lisa
    Y1  - 2018/10/10
    PY  - 2018
    N1  - https://doi.org/10.11648/j.ijcu.20180202.11
    DO  - 10.11648/j.ijcu.20180202.11
    T2  - International Journal of Clinical Urology
    JF  - International Journal of Clinical Urology
    JO  - International Journal of Clinical Urology
    SP  - 25
    EP  - 29
    PB  - Science Publishing Group
    SN  - 2640-1355
    UR  - https://doi.org/10.11648/j.ijcu.20180202.11
    AB  - Posterior urethral valves are the commonest cause of bladder outlet obstruction in boys. The incidence varies from 1 in 5000 to 25,000 live birth worldwide. The incidence in lower and middle- income countries is unknown due to paucity of data. . The aim of this study was to review the presentation, management and outcome of posterior urethral valve at the Abia State University Teaching Hospital Aba, Nigeria. Patients and Methods: Fifteen boys with posterior urethral valve seen at the Abia State University Teaching Hospital Aba from January 2016 to June 2018 were included in the study. Data collected includes demographic data, clinical features, and duration of symptoms, serum biochemistry, radiological diagnosis, surgical management and outcome. Results: The patient age ranged from 2 weeks to 2 years, Median age of 6 months. 7(46.6%) of the patients were neonates. The commonest symptoms were voiding dysfunction, distended bladder and anaemia. Duration of symptoms was 2weeks in 6 (40%) patients, 4 weeks in 4(27) patients and 8weeks in 5(33%) patients. 2(13%) patients had grade 2 vesicoureteric reflux on expressive cystourethrogram. All the patients had foley catheter avulsion of posterior urethral valve. There was no case of frank haemorrhage but haematuria was noticed which resolved spontaneously. Fourteen (93.3%) out of 15 patients reported consistent good urinary stream without evidence of renal deterioration. A patient (6.6%) had persistent straining at micturition requiring a repeat Foley catheter balloon avulsion. All mothers were satisfied with the outcome of treatment due to good post- operative urinary stream. There was complete resolution of the vesicoureteric reflux at 6 months post valve ablation expressive cystourethrogram. The post -operative urinary stream, serum electrolyte, and urea and cretinine status remained normal during follow up period of 6 months. Conclusion: Posterior urethral valve is a common cause of bladder outlet obstruction in boys, high index of suspicion will lead to early diagnosis, late presentation still persist due to poor knowledge of health care workers in our environment.
    VL  - 2
    IS  - 2
    ER  - 

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Author Information
  • Department of Surgery, Abia State University, Aba, Nigeria

  • Department of Paediatrics, Abia State University, Aba, Nigeria

  • Department of Surgery, Abia State University, Aba, Nigeria

  • Department of Radiology, Abia State University, Aba, Nigeria

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