Aggressive diagnosis and treatment for posterior urethral valve as an etiology for vesicoureteral reflux or urge incontinence in children

Investig Clin Urol. 2017 Jun;58(Suppl 1):S46-S53. doi: 10.4111/icu.2017.58.S1.S46. Epub 2017 Jun 7.

Abstract

Vesicoureteral reflux (VUR) is one of the most common diseases in pediatric urology and classified into primary and secondary VUR. Although posterior urethral valve (PUV) is well known as a cause of the secondary VUR, it is controversial that minor urethral deformity recognized in voiding cystourethrography represents mild end of PUV spectrum and contributes to the secondary VUR. We have been studying for these ten years congenital urethral obstructive lesions with special attention to its urethrographic and endoscopic morphology as well as therapeutic response with transurethral incision. Our conclusion to date is that congenital obstructive lesion in the postero-membranous urethra is exclusively PUV (types 1 and 3) and that severity of obstruction depends on broad spectrum of morphological features recognized in PUV. Endoscopic diagnostic criteria for PUV are being consolidated.

Keywords: Urethral obstruction; Urinary incontinence; Vesicoureteral reflux.

Publication types

  • Review

MeSH terms

  • Child
  • Child, Preschool
  • Congenital Abnormalities / diagnostic imaging
  • Congenital Abnormalities / surgery
  • Endoscopy
  • Humans
  • Infant
  • Infant, Newborn
  • Urethra / abnormalities*
  • Urethra / diagnostic imaging
  • Urethra / surgery
  • Urinary Incontinence, Urge / etiology*
  • Urography
  • Vesico-Ureteral Reflux / etiology*