Outcome and Short Term Follow up of Children with Posterior Urethral Valves: Prognostic Factors

Posterior urethral valves (PUV) are the commonest cause of renal impairment in boys during early childhood. Despite a systematic approach in deciding choice of therapy in each case, renal failure is seen in 25-40% of posterior urethral valves (PUV) at varying ages [1]. Aim of the workTo identify the prognostic factors in patients with posterior urethral valve and help in defining the end result and implicating the correct treatment proto?col. Patients and methodsThis study reviews retrospectively a series of 50 children with posterior urethral valves who pre'sented at department of pediatric surgery, Zagazig university hospital, Egypt in the period from 2009 to 2014, These included age at presentation and intervention (less than or more than 2 years), recurrent urosepsis, pres?ence of vesico-ureteric reflux, renal parenchymal dam?age as seen on ultrasound, vesical dysfunction and the nadir serum creatinine level. Results 29% of children had renal insufficiency at the end of 2-years' follow-up. Factors important in the progression towards renal insufficiency were evaluated. Factors found to be statistically signifi?cant with a p value less than0.05 were, age at intervention more than 2 years, recurrent urosepsis, bilateral high grade vesico-ureteric reflex, bilateral parenchymal damage as seen on ultrasonography and nadir serum creatinine of more than 0.8 mg%. Conclusion prognostic factors in patients with posterior urethral valve depend on, age of intervention, and recurrent urosepsis, and degree of reflux, and degree of renal damage, and serum creatinine.