POSTERIOR URETHRAL VALVES IN CHILDHOOD: EXPERIENCE IN A CENTER WITH SCARCE FACILITIES

Objective: Posterior urethral valves (PUV) are the most common congenital causes of lower urinary tract obstruction in male children, but few cases have been reported from Nigeria. In this study we describe our 7-year experience of management of PUV in children in order to increase the awareness of this condition in our environment. Patients and Methods: This is a report of 41 consecutive children with PUV who were managed at the Jos University Teaching Hospitals (JUTH), Jos, Nigeria, from June 2000 toApril 2006. Theirage at presentation ranged from 2 days to 15 years (mean: 2.5 years). The relevant clinical, laboratory and radiological data were entered into a database and analyzed. Results: Twenty-eight patients presented with a condition highly suspicious of PUV, while 7 patients presented with other urological conditions. Six patients presented with non-urological symptoms which caused a delay in diagnosis and institution of treatment. Voiding cystourethrography was diagnostic in all cases. In the majority of patients (n=31), management consisted of transurethral balloon avulsion of the valves yielding a satisfactory outcome in over 80% of the patients. Urethral stricture was the main complication (which responded to serial dilatation) and occurred in 3 patients. The postoperative mortality rate was 2.6%. Conclusion: Although this study was restricted to one hospital, there appears to be a high incidence of PUV in children in North Central Nigeria. An increased awareness of varied clinical features, a high index of suspicion and simple conservative treatment by balloon avulsion of PUV would improve the outcome.