CHILD SURGEON
POSTERIOR URETHERAL VALVE (PUV)
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Video in English
Posterior Urethral Valve (PUV) is a condition exclusive to male infants, characterized by abnormal flaps of tissue in the urethra, the tube that helps drain urine from the bladder. These flaps act as a blockage, disrupting normal urine flow. This condition can lead to several health issues. The bladder, faced with resistance, has to work harder to expel urine, causing it to become overactive and less elastic. This increased effort can lead to bladder muscle thickening. Over time, the retained urine increases the risk of urinary infections and bladder damage. More severely, the backflow of urine can affect the kidneys, leading to potential kidney damage. Symptoms of PUV can include a weak urine stream, difficulty in urination, frequent urinary infections, and a swollen bladder. The condition is often detected through prenatal ultrasounds or postnatal symptoms. Early detection is key for effective management and prevention of long-term complications.
Surgery related
The primary treatment for PUV involves surgical intervention to remove the obstructive tissue. This procedure, typically done through an endoscopic method, is minimally invasive. An endoscope, a thin tube with a camera and light, is inserted through the urethra, allowing the surgeon to view and remove the blockage without external incisions. This procedure is generally safe and effective in relieving the obstruction. However, in cases where endoscopic surgery is not feasible immediately due to various medical reasons, alternative measures are taken. Temporary solutions like catheterization might be employed to relieve pressure on the bladder and kidneys. This involves inserting a tube to drain urine directly from the bladder. In more severe cases, where the kidneys are at risk, surgical creation of a new pathway for urine drainage from the kidneys, known as vesicostomy or ureterostomy, might be necessary. These procedures ensure urine drainage, thus protecting the kidneys from further damage. Post-surgery, regular monitoring and possible long-term management are essential for optimal recovery and function.
Follow up
The long-term outcomes for children with PUV vary and largely depend on the severity of the condition at diagnosis and the effectiveness of the treatment. Early intervention generally leads to better outcomes, with many children leading normal, healthy lives. However, even with successful treatment, the condition can have lasting effects on the urinary and renal systems. Regular follow-up visits are essential for monitoring kidney and bladder health. These check-ups help in identifying and managing any lingering issues like reduced bladder capacity, urinary incontinence, or kidney function impairment. Some children may require ongoing medication or other treatments to aid bladder function and prevent urinary tract infections. In cases where kidney damage is significant, long-term treatments, including potential kidney transplantation, may be necessary. The key to ensuring a good quality of life for these children is continuous medical care and monitoring. With proper management, many individuals with PUV can avoid severe kidney problems and maintain a normal lifestyle. Parents and caregivers play a crucial role in adhering to treatment plans and regular medical consultations to safeguard the child's health.