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12. Management of Posterior Urethral Valves in Public Sector Hospital: Challenges Faced

1. Muhammad Kashif  2. Asif Abbas 3. Mukhtar Hussain

1. Assoc. Prof. of Paediatric Surgery, 2. Asstt. Prof. of Paediatric Surgery, 3. Prof. of Paediatric Surgery,  The Children Hospital & Institute of Child Health, Multan

ABSTRACT

Objective: To adjudge the mode of presentation, upshot of treatment and complications of posterior urethral valve in our habitat.

Study Design: Descriptive  study   

Place and Duration of Study; This study was conducted at Department of Pediatric Urology, The Children’s Hospital & ICH Multan from 1st  October  2012 to October  2014

Subjects and Methods: All the information were entered on a structured sheet, like presenting features with their duration, treatment  done and its outcome, complications of the disease. The data was later analyzed with the help of software.

Results: Two hundred thirty patients were included in the study. Median age ranges from  3days–10 years (median age2.5 years). Mean time tenure before clinical presentation was 2.5 years. Obstructive symptoms were present in all patients while UTI was second most common and present in two hundred and ten patients (91%) , Vesicoureteral reflux was seen in eighty patients (35%) , Neurogenic bladder was present in thirty five (15%), and forty patients (17%) presented with significant renal parenchymal damage. Micturating  cystourethrogram confirmed the findings of posterior urethral valve. Cystoscopy and fulguration of valves was done in all patients and supra vesical diversion was done later in selected cases.

Conclusion: Study results concluded that delayed presentation of the disease is customary in our society. This is linked with lofty morbidity and mortality rates. Efforts should be made in improving awareness among healthcare professionals at primary and secondary care centre for early diagnosis and treatment.

Key Words: Urosepsis, Vesicoureteral reflux, Renal insufficiency, Vesicostomy, Ureterostomy  

Citation of article: Kashif  M, Abbas A, Hussain M. Management of Posterior Urethral Valves in Public Sector  Hospital: Challenges Faced. Med Forum 2015;26(7):43-46.