title: Posterior Urethral Valves; A single Center Experience.
abstract: OBJECTIVE
  Posterior urethral valves (PUV) are the most common cause of bladder outlet obstruction in infancy that impair renal and bladder function. This study was planned to evaluate and record the various clinical presentations and management, complications, and surgical management and long-term outcome of PUV.
  
  
  METHODS
  In a retrospective study, 98 patients who have been treated for PUV are evaluated in Mofid Children's Hospital from January 2007 to December 2012. Detailed history taken and paraclinical examinations were performed in each patient and diagnosis was confirmed by voiding-cysto-urethrography (VCUG). PUV had been ablated in 62 patients by electric hook, and diversion was performed in 42 (42.85%) cases. Data were analyzed by SPSS software version18.
  
  
  RESULTS
  Totally 98 patients with mean age at diagnosis 62 (±13) days were included in this study. Fifty seven cases had been catheterized within one to 6 days of life (mean age one day), PUV was ablated in 62 patients by electric hook, and diversion was performed in 42 cases. The most common symptom in our group was dribbling poor stream 51% and urinary tract infection (UTI) 40.8%. There was vesico-ureteral-reflux (VUR) in 61.2%, and hydronephrosis in 82.6%. Most common associated anomaly was kidney anomalies (multicystic kidney disease and renal agenesis/dysplasia) in 8 (8.2%) patients. Twenty patients had prenatal diagnosis of PUV. Complication occurred in three (3.1%) patients. Mortality occurred in 5 (5.1%) patients. Mean follow-up period was 3.4±1.2 years (1.5 months to 5 years).
  
  
  CONCLUSIONS
  Urinary drainage by feeding tube in early days of infancy, followed by valve ablation is the best treatment in PUV, and urinary diversion improves the outcome. VCUG is still the gold-standard imaging modality for documenting PUVs. The factors like renal dysplasia and UTI have their role in final outcome.
authors.affiliation: Pediatric Surgery Research Center, Shaheed Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Alireza
authors.initials: A
authors.lastname: Mirshemirani
authors.affiliation: Pediatric Surgery Research Center, Shaheed Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Khaleghnejad
authors.affiliation: Pediatric Surgery Research Center, Shaheed Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Mohsen
authors.initials: M
authors.lastname: Rouzrokh
authors.affiliation: Department of Pediatric Anesthesiology, Shaheed Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Afsaneh
authors.initials: A
authors.lastname: Sadeghi
authors.affiliation: Pediatric Surgery Research Center, Shaheed Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Leila
authors.initials: L
authors.lastname: Mohajerzadeh
authors.affiliation: Pediatric Nephrology Research Center, Shaheed Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Sharifian
keywords: Children; Outcome; PUV; Urinary Diversion; Urinary Drainage; Valve Ablation