title: Late diagnosis of posterior urethral valves.
abstract: OBJECTIVE
  We diagnosed 8 patients with late-stage posterior urethral valves (PUV) between 1 and 14 years of age. Five patients complained of symptoms related to voiding dysfunction. The other 3 patients required urethrocystoscopy for other reasons (hypospadias fistulae, difficulty with catheterisation and high-grade vesicoureteral reflux [VUR]). A second review of the first 2 patients' medical history showed voiding dysfunction symptoms. All patients underwent preoperative ultrasonography: 3 patients had normal results and 5 had renal or vesical disorders. The diagnosis was reached through voiding cystourethrogram (VCUG), and 4 patients underwent urodynamic studies. The diagnosis was confirmed by urethrocystoscopy, performing valve electrofulguration. We performed urethrocystoscopy during the check-ups at 3-6 weeks and observed no stenosis. The symptoms disappeared for all patients after 20 months of follow-up. The patient with VUR was cured. The ultrasounds showed no progression of the renal involvement and showed improvement in the vesical involvement. The velocimetries during check-ups presented curves within normal ranges.
  
  
  CONCLUSIONS
  Most children with PUV are diagnosed through ultrasound during the neonatal period. Some patients present PUV at later ages with diverse symptoms, which impedes its diagnosis. We should suspect PUV in male patients with symptoms of voiding dysfunction, either when they have normal or pathological results from ultrasounds or VCUG. We recommend performing urethrocystoscopy to rule out urethral obstruction.
authors.affiliation: Sección de Urología Pediátrica, Servicio de Cirugía Pediátrica, Hospital Infantil Gregorio Marañón, Madrid, España. Electronic address: mariazornoza@gmail.com.
authors.forename: M
authors.initials: M
authors.lastname: Zornoza
authors.affiliation: Sección de Urología Pediátrica, Servicio de Cirugía Pediátrica, Hospital Infantil Gregorio Marañón, Madrid, España.
authors.forename: J M
authors.initials: JM
authors.lastname: Angulo
authors.affiliation: Sección de Urología Pediátrica, Servicio de Cirugía Pediátrica, Hospital Infantil Gregorio Marañón, Madrid, España.
authors.forename: A
authors.initials: A
authors.lastname: Parente
authors.affiliation: Sección de Urología Pediátrica, Servicio de Cirugía Pediátrica, Hospital Infantil Gregorio Marañón, Madrid, España.
authors.forename: S
authors.initials: S
authors.lastname: Simal
authors.affiliation: Sección de Urología Pediátrica, Servicio de Cirugía Pediátrica, Hospital Infantil Gregorio Marañón, Madrid, España.
authors.forename: L
authors.initials: L
authors.lastname: Burgos
authors.affiliation: Sección de Urología Pediátrica, Servicio de Cirugía Pediátrica, Hospital Infantil Gregorio Marañón, Madrid, España.
authors.forename: R
authors.initials: R
authors.lastname: Ortiz
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D057210:Delayed Diagnosis; D006801:Humans; D007223:Infant; D008297:Male; D014521:Urethra / Q000002:abnormalities*; D014522:Urethral Diseases / Q000175:diagnosis* / Q000209:etiology
keywords: Disfunción de vaciado; Electrofulguración; Electrofulguration; Posterior urethral valves; Urethrocystoscopy; Uretrocistoscopia; Voiding dysfunction; Válvulas de uretra posterior