title: Congenital anterior urethral valve with or without diverticulum: a single-centre experience.
abstract: BACKGROUND
  Congenital anterior urethral valves (AUV) are rare and can occur as an isolated entity or in association with proximal diverticula. Diagnosis may be overlooked and ideal treatment is not standardized when both the valve and diverticulum are simultaneously present. We present our experience of congenital AUV.
  
  
  METHODS
  From January 2007 to June 2012 a retrospective review of the medical records of 7 cases of AUV was performed.
  
  
  RESULTS
  Three patients were diagnosed as isolated AUV while four presented with associated diverticula. The age of presentation ranged from 10 months to 6 years. Weak voiding stream and dribbling were the most common symptoms. Renal function was found to be deranged in two patients (28%). Hydro-ureteronephrosis was present in three boys (42%) and reflux was present in one patient. Post-void residual volume was >20 ml (mean 55 ml) in all children. Transurethral holmium laser fulguration was carried out on isolated AUV or AUV with small diverticula. Open resection and reconstruction or plication was performed in patients with AUV and proximal large (>3 cm) diverticula. Surgical outcome was successful in all patients except for occurrence of urethrocutaneous fistula in one patient.
  
  
  CONCLUSIONS
  In isolated AUV or valve with associated small diverticulum, transurethral holmium:YAG laser ablation is the treatment of choice. Primary excision and repair or plication are preferred if a large diverticula has formed. Eventual outcomes of AUV are good if irreversible changes have not been established.
authors.affiliation: Department of Urology, King George's Medical University, (Formerly, Chhatrapati Shahuji Maharaj Medical University), Lucknow, India.
authors.forename: Jai
authors.initials: J
authors.lastname: Prakash
authors.forename: Divakar
authors.initials: D
authors.lastname: Dalela
authors.forename: Apul
authors.initials: A
authors.lastname: Goel
authors.forename: Vishwajeet
authors.initials: V
authors.lastname: Singh
authors.forename: Manoj
authors.initials: M
authors.lastname: Kumar
authors.forename: Manish
authors.initials: M
authors.lastname: Garg
authors.forename: Swarnendu
authors.initials: S
authors.lastname: Mandal
authors.forename: Satya N
authors.initials: SN
authors.lastname: Sankhwar
authors.forename: Sagorika
authors.initials: S
authors.lastname: Paul
authors.forename: Bhupender P
authors.initials: BP
authors.lastname: Singh
mesh_terms: D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D004240:Diverticulum / Q000151:congenital / Q000000981:diagnostic imaging / Q000601:surgery*; D004724:Endoscopy / Q000379:methods; D006801:Humans; D007223:Infant; D053685:Laser Therapy / Q000379:methods*; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D008297:Male; D011859:Radiography; D012189:Retrospective Studies; D013812:Therapeutics; D014521:Urethra / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D014522:Urethral Diseases / Q000151:congenital / Q000000981:diagnostic imaging / Q000601:surgery*; D014549:Urinary Incontinence / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery
keywords: Anterior urethral valve; Diverticula