title: Long-term bladder function, fertility and sexual function in patients with posterior urethral valves treated in infancy.
abstract: OBJECTIVE
  To address the issue of sexual function and fertility in PUV patients.
  
  
  METHODS
  Of 47 patients (age > 18 years) treated for PUV in infancy 28 were contactable. They were sent a standard questionnaire requesting details on voiding dysfunction symptoms, and experience of erection, orgasm and ejaculation.
  
  
  RESULTS
  Of the 28, 16 (mean age 24 years) returned the questionnaire. Voiding frequency ranged from 3 to 10 times per day (mean = 5). Two patients had occasional mild diurnal incontinence but none had symptoms of overactivity. Three patients had a weak urinary stream. Renal function was normal in 9, 4 had a glomerular filtration rate <80 ml/min/1.73 m(2), and 3 had undergone renal transplant. Erections and orgasm were experienced by the 15 patients who responded to these questions, with 4 reporting mild or medium erectile dysfunction and 1, on dialysis, reporting slow ejaculation. Post-masturbation samples of semen and urine were collected from 6 patients. One had an alkaline pH, high percentage of immotile sperm and low sperm count. Another had a high concentration of abnormal forms, and seminal fluid was present in the urine of 3 patients.
  
  
  CONCLUSIONS
  In long-term follow-up, 44% of PUV patients develop chronic renal failure or end-stage renal disease, but bladder dysfunction symptoms are infrequent. Sexual function is mostly normal. Total semen counts and motility are compatible with paternity in most patients.
authors.affiliation: Department of Paediatric Urology, University Hospital La Paz, Madrid, Spain. plpuro@hotmail.com
authors.forename: P
authors.initials: P
authors.lastname: López Pereira
authors.forename: M
authors.initials: M
authors.lastname: Miguel
authors.forename: M J
authors.initials: MJ
authors.lastname: Martínez Urrutia
authors.forename: J A
authors.initials: JA
authors.lastname: Moreno
authors.forename: M
authors.initials: M
authors.lastname: Marcos
authors.forename: R
authors.initials: R
authors.lastname: Lobato
authors.forename: E
authors.initials: E
authors.lastname: Jaureguízar
mesh_terms: D000293:Adolescent; D000328:Adult; D004542:Ejaculation / Q000502:physiology; D007172:Erectile Dysfunction / Q000209:etiology; D005500:Follow-Up Studies; D006801:Humans; D007248:Infertility, Male / Q000209:etiology; D008297:Male; D010410:Penile Erection / Q000502:physiology; D011379:Prognosis; D012189:Retrospective Studies; D012735:Sexual Dysfunction, Physiological / Q000209:etiology*; D020018:Sexual Dysfunctions, Psychological / Q000209:etiology; D011795:Surveys and Questionnaires; D014521:Urethra / Q000002:abnormalities* / Q000601:surgery*; D014525:Urethral Stricture / Q000601:surgery*; D001743:Urinary Bladder / Q000502:physiology; D001745:Urinary Bladder Diseases / Q000209:etiology*; D014555:Urination Disorders / Q000209:etiology*; D014563:Urodynamics / Q000502:physiology; D055815:Young Adult