Posterior urethral valves: the scenario in a developing center.
We have reviewed 233 patients with posterior urethral valves treated in a single center in Calcutta, India, over the last 20 years: 37 were neonates, 75 were between 1 and 12 months, 88 were between 1 and 5 years, and 33 were more than 5 years old when first seen. The clinical presentation and methods employed in diagnosis and assessment are described. Primary endoscopic valve ablation was performed in 140 patients (60%). One or other form of diversion was done in 100 (43%), 93 before and 7 either during or after valve ablation. The short- and long-term results have been studied. Eleven patients died during the initial hospitalization, 3 died subsequently, 15 are in end-stage renal disease, 17 are in poor health, and 18 have been totally lost to follow-up. The remaining 169 have been in good health for periods between 1 and 20 years. While our results of primary valve ablation in low-risk patients with responsible parents are as good as anywhere else in the world, we are concerned at our relatively high diversion rate and relatively poor long-term follow up; the methods being adopted to reduce these problems are discussed.
Chatterjee
S K
SK
Department of Surgery, Park Children's Center for Treatment and Research, Calcutta, India.
Banerjee
S
S
Basak
D
D
Basu
A K
AK
Chakravarti
A K
AK
Chatterjee
U S
US
Haque
J
J
D002675:Child, Preschool; D003559:Cystostomy; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D009403:Nephrostomy, Percutaneous; D014521:Urethra / Q000002:abnormalities* / Q000601:surgery*; D014524:Urethral Obstruction / Q000601:surgery*; D014547:Urinary Diversion; D013520:Urologic Surgical Procedures; D014718:Vesico-Ureteral Reflux / Q000601:surgery