title: Posterior Urethral Valves in Children: Pattern of Presentation and Outcome of Initial Treatment in Ile-Ife, Nigeria.
abstract: BACKGROUND
  The management of posterior urethral valves (PUV) and its sequelae is still a challenge to most pediatric surgeons in our environment due to late presentation and inadequate facilities for long-term evaluation and treatment. Despite initial successful treatment about 40% would develop chronic renal failure. The aim is to describe the presentation, management and outcome of the initial treatment in boys with PUV.
  
  
  METHODS
  It is a retrospective analysis of PUV in boys 8 years and below over a 17 years period. Demographic characteristics, clinical features, investigations, and treatment outcome were reviewed.
  
  
  RESULTS
  Thirty-seven cases were analyzed. The median age was 5 months (range from birth to 8 years). Three (8.1%) patients had prenatal ultrasound diagnosis. The most common presentation was voiding dysfunction 37 (100%). Part of the preoperative investigation included micturating cystourethrogram (n = 31: 83.8%) and abdomino-pelvic ultrasonography (n = 37:(100%). The mean serum creatinine value of those who presented within the first 30 days of life and those who presented afterwards were 325 (±251) µmol/L and 141 (±100) µmol/L respectively, P = 0.003. Surgical interventions included trans-vesical excision of valves (n = 9: 28.1%), valvotomy (n = 10: 31.3%), balloon avulsion (n = 8: 25.0%), vesicostomy (n = 4: 12.5%) and endoscopic valve avulsion (n = 1: 3.1%). Seventeen (56.7%) patients had serum creatinine >70.4 µmol/L after 1-month of valve excision. Five (13.5%) patients had postrelief complications and 5 (13.5%) died on admission. Ninety percentage (27/30) of patients had poor prognostic indices.
  
  
  CONCLUSIONS
  The initial treatment outcome was good but most had poor prognostic factors.
authors.affiliation: Department of Sugery, Obafemi Awolowo University Teaching Hospitals Complex, Obafemi Awolowo University, Ile-Ife Osun State, Southwest Nigeria.
authors.forename: Ademola Olusegun
authors.initials: AO
authors.lastname: Talabi
authors.affiliation: Department of Sugery, Obafemi Awolowo University Teaching Hospitals Complex, Obafemi Awolowo University, Ile-Ife Osun State, Southwest Nigeria.
authors.forename: Oludayo Adedapo
authors.initials: OA
authors.lastname: Sowande
authors.affiliation: Department of Sugery, Obafemi Awolowo University Teaching Hospitals Complex, Obafemi Awolowo University, Ile-Ife Osun State, Southwest Nigeria.
authors.forename: Amarachukwu Chiduziem
authors.initials: AC
authors.lastname: Etonyeaku
authors.affiliation: Department of Sugery, Obafemi Awolowo University Teaching Hospitals Complex, Obafemi Awolowo University, Ile-Ife Osun State, Southwest Nigeria.
authors.forename: Abdulkadir A
authors.initials: AA
authors.lastname: Salako
authors.affiliation: Department of Sugery, Obafemi Awolowo University Teaching Hospitals Complex, Obafemi Awolowo University, Ile-Ife Osun State, Southwest Nigeria.
authors.forename: Olusanya
authors.initials: O
authors.lastname: Adejuyigbe
keywords: Excision; treatment outcome; urethral valves