URETHRAL VALVE FULGERATION

URETHRAL VALVE FULGERATION

Posterior urethral valves or PUV are thick prominent urethra folds beginning below the level of verumontanum which prevents urine from flowing freely from the urinary bladder. When PUV prevents the backpressure of the urine flow to the posterior urethra, ureters, urinary bladder, and kidneys are exerted. That begins the child with obstructive harm from prenatal time.

What are the causes of posterior urethral valves?

Some people think that this is an inherited condition, but PUV is not inherited in any recognized manner. This condition happens in the early stages of pregnancy when the muscles, organs, and other tissues begin to develop in an unborn baby. It is completely a myth that mom did something or ate a harmful thing during her pregnancy

What are the symptoms of PUV?

PUV is correlated with different signs but they do not impact any child in the same way. The degree of blockage has an impact on symptom frequency.There are some symptoms which include:

  • An enlarged bladder, so you can feel it like a lump through the abdomen
  • Infections of the urinary tract (UTI)
  • Hardy urinating
  • A small amount of urine
  • Extraordinarily frequent urination
  • Wetting the bed after training toilet was successful
  • Deprived weight gain

 

What decides the future of the child with PUV?

  • Regular follow-ups
  • Thick prominent valves
  • Pop off mechanisms including Urinoma, Vesico ureteric reflux on one side and Bladder diverticulum
  • Early Management
  • Renal dysplasia

What to do after Posterior urethral valves have been found in prenatal form?

f PUV is diagnosed and confirmed with oligohydramnios and lung hypoplasia during the TIFFA scan, the termination can be discussed with the pediatric surgeon during antenatal counseling. In comparison to the Obstetrician, the pediatric surgeon may address the unborn child ‘s diagnosis, perinatal treatment preparation, and long-term prognosis.

After childbirth assessment

The clinical suspicion is sustained by palpable urinary bladder, high serum creatinine after 24 hours, and poor urine stream. Ultrasound KUB and Voiding cystourethrography (VCU / MCUG) confirm the Posterior urethral valve diagnosis.

Management of PUV
  • Valve clearing-: Cystoscopy and primary valve fulguration is the standard gold treatment for PUV management. Treatment begins with the fulguration of the valves. Lifetime follow-ups are compulsory with pediatric nephrologists and medical management.
  • Vesicostomy-: In certain special situations vesicostomy is performed and at a later date, as decided by the pediatric surgeon, a fulguration with vesicostomy closure is performed.
  • End stage renal disease (ESRD)-: in the probability and treatment of PUV children depends on the extent of the valve and the impact of strain on the upper tracts because it is an inevitable improvement.
  • Long-term care-: When your child enters adulthood, you need to visit the specialist for urology transitional care program. This program is designed to provide your child with proper care. Patients who are suffering from severe conditions such as PUV, it will be effective.

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When do I contact the doctor?

You need to consult the doctor immediately in case of seizures and blackouts. While some of these symptoms may be a result of other medical condition, it is always advisable to receive immediate medical attention. Repeated seizures can cause serious injury and must never be ignored.

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