Urodynamic findings of posterior urethral valve patients

The most frequently observed cause of obstructed bladder in children is the posterior urethral valve (PUV). In this report, we analysed the urodynamic findings of 26 patients whose valves were fulgurated 12.6 months previously (range: 2 days - 8 years, after the fulguration). The mean age of the patients at the time of the procedure was 4.5 years (range: 2 months - 13 years). Bladder capacity was decreased in 15, increased in 6, and normal in 5 patients; hypocompliance was observed in 13, hypercompliance was observed in 4, and normocompliance was observed in 9 children. Generally, hypocompliance and decreased bladder capacity was more frequent in patients younger than 4 years of age. There were 10 patients with instable detrusor contractions (IDC) and high residual urine was present in 8 patients. Eight patients developed chronic renal failure and 6 of these patients had high residual urine. All the patients who required bladder augmentation during follow-up were the ones treated after 2.5 years of age: 4 of these 5 patients had hypocompliance and low bladder capacity on urodynamic studies. In conclusion, all patients with PUV had pathological urodynamic findings that could change with age, and early relief of the infravesical obstruction could have an improving effect on bladder function. Urodynamic investigations may help us to design the proper treatment according to the bladder function.