Recent advancements in antenatal ultrasound and endoscopy have altered the presentation and management of PUV. Herein we describe the presentation, management and outcome of PUV patients in Eastern Ontario/Western Quebec over the last 3 decades. [ncbi.nlm.nih.gov]

• Ascites

  Urinary ascites, particularly after vesicocentesis, should be observed with extreme caution. [ncbi.nlm.nih.gov]

  INTRODUCTION Ascites is a rare condition in neonates and generally may present several etiologies, urinary ascites being most frequently found(1,2). [rb.org.br]

  & urinary ascites 10 0.5 PUV + left VUR Good function bilaterally Valve ablation 4 6M Abdominal distension Bilateral hydrouretero-ne- phrosis, thick wall bladder with left peri-renal urinoma & urinary ascites 10 0.7 PUV +bilat. [jpss.eu]

  On prenatal sonography, oligohydramnios, hydronephrosis with or without parenchymal thinning, bladder distention, and fetal ascites may be seen. [advancedradteaching.com]

• Pain

  Management Frontiers in Medicine Epidemics Zika Virus Ebola Virus View all topics Health Policy Epidemics Pain Management Ebola Virus Multimedia Multimedia Selected Multimedia View all multimedia Audio Clinical Practice Audio Interviews Interactive Medical [nejm.org]

  They include Urethral cancer - a rare cancer that happens more often in men Urethral stricture - a narrowing of the opening of the urethra Urethritis - inflammation of the urethra, sometimes caused by infection Urethral problems may cause pain or difficulty [icdlist.com]

  Babies and children with UTIs may become irritable, have a fever, have pain on weeing, feel sick or be sick, or have diarrhoea. [infokid.org.uk]

  […] and Mental Health Program are at the forefront of scientific discovery and translation across a broad range of research areas, including stroke, brain injury and rehabilitation, neuroscience, mental and physical health, cognition (psychology), ageing, pain [hmri.org.au]

• Swelling

  T gans of the urinary tract become engorged with urine and swell, causing tissue and cell damage. The degree of urinary outflow obstruction will determine the severity of the condition. [web.archive.org]

  Depending on the extent of blockage, the organs can swell, causing damage to the tissues and cells within those organs. How Is Fetal PUV Diagnosed? Fetal PUV can be diagnosed by ultrasound (sonogram) examination before birth. [luriechildrens.org]

  B/o A.S., was found to have swelling of both kidneys (bilateral hydronephrosis) before birth at 28 weeks by ultrasound. [pediatricurology.in]

  The backup of urine can damage the bladder, kidneys and other parts of the urinary tract, as it causes the organs to swell. That can lead to damage of the tissues and cells within the urinary tract. [beaumont.org]

  This results in high pressure inside the bladder which gets transmitted to the kidneys resulting in its swelling which my adversely affect the functioning of the kidneys. [specialistshospital.com]

• Weakness

  All considered their ejaculations normal and only one complained of weak ejaculations. Four of 5 patients who consented to perform a semen analysis had normal tests and 1 had low sperm count with abnormal motility. [ncbi.nlm.nih.gov]

  Symptoms of urethral valves can vary from child to child and may include: an enlarged bladder, which may be detectable through the abdomen as a large mass urinary tract infection painful urination weak urine stream urinary frequency bedwetting or wetting [childrenshospital.org]

  Some symptoms include: an enlarged bladder, so that it can be felt through the abdomen as a lump urinary tract infections (UTIs) difficulty urinating a weak stream of urine unusually frequent urination bed wetting after toilet training has been successful [gosh.nhs.uk]

  Other warning signals include a continual dribbling of urine and a weak stream during urination. More commonly though, posterior urethral valve is diagnosed when the boy develops a urinary tract infection with fever and poor feeding. [healthychildren.org]

• Weight Gain

  Poor weight gain. Urinary tract infection. Painful urination. Kidney failure. The symptoms of PUV may resemble other conditions or medical problems. [choc.org]

  […] and may include: an enlarged bladder, which may be detectable through the abdomen as a large mass urinary tract infection painful urination weak urine stream urinary frequency bedwetting or wetting pants after your child has been;toilet-trained poor weight [childrenshospital.org]

  gain However, these symptoms can resemble those of other conditions, so parents should always check with the doctor. [gosh.nhs.uk]

  gain Difficulty with urination The symptoms of PUV may resemble other conditions or medical problems. [stanfordchildrens.org]

• Respiratory Insufficiency

  Due to deficiency of liquor, the baby’s lungs were also not fully developed and the baby had mild respiratory insufficiency requiring NICU care for 3-4 days. At this stage we were consulted. [pediatricurology.in]

• Failure to Thrive

  Neonatal presentation: anuria palpable bladder rapidly developing renal failure First year of life presentation: failure to thrive vomiting poor stream, dribbling, incontinence often develop sepsis Diagnosis is made on micturating cystourethrography. [gpnotebook.co.uk]

  Newborns may also be brought with few urinary symptoms and more non specific ones like abdominal distension, failure to thrive, signs of infection (sepsis) somewhere in the body, recurrent urinary infections with fever. [pediatriconcall.com]

  If the obstruction is severe and remains unrecognized during the neonatal period, infants may present later in life with failure to thrive due to uremia or sepsis caused by infection in the obstructed urinary tract. [archintsurg.org]

  Loss of weight, unexplained fever, failure to thrive and bouts of diarrhoea are significant findings. Palpable urinary bladder and kidneys in these cases give a clue. [jpma.org.pk]

• Abdominal Distension

  Case Age Cause of referral Postnatal USS Initial s. creat mg/dL Last s. creat mg/dL MCUG Isotope scan Tratament 2 3H Abdominal distension. Antenatal USS. [jpss.eu]

  Pathology by systems > Urinary system > Urethra > posterior urethral valve Synopsis Prune-Belly sequence cystomegaly (megacystis) abdominal distension abdominal musculature hypoplasia bilteral ureteral dilatation renal lesions bilateral renal dysplasia [humpath.com]

  It is a case of a 22-day-old full-term male child who presented with poor urinary stream and progressive abdominal distension of 5-day duration as well as leakage of clear fluid from umbilicus of 1-day duration. [urologyannals.com]

  Newborns may also be brought with few urinary symptoms and more non specific ones like abdominal distension, failure to thrive, signs of infection (sepsis) somewhere in the body, recurrent urinary infections with fever. [pediatriconcall.com]

  Abdominal distension noted was due to the presence of ballotable hydronephrotic kidneys and urinary ascites while the presence of fever was mostly due to complications such as UTI and septicemia. [afrjpaedsurg.org]

• Vomiting

  Neonatal presentation: anuria palpable bladder rapidly developing renal failure First year of life presentation: failure to thrive vomiting poor stream, dribbling, incontinence often develop sepsis Diagnosis is made on micturating cystourethrography. [gpnotebook.co.uk]

  Once the urinary system is blocked by the PUV then infection of the urine (urinary tract infection) can occur and baby may get very sick with a temperature and vomiting and occasionally convulsions. [kidney.org.uk]

  Vomiting was not observed, only a regurgitation episode in the previous day was reported. [rb.org.br]

• Regurgitation

  Vomiting was not observed, only a regurgitation episode in the previous day was reported. [rb.org.br]

• Suggestibility

  Evidence is presented which suggests that these two conditions may coexist. [ncbi.nlm.nih.gov]

• Renal Insufficiency

  insufficiency on long-term follow-up. [ncbi.nlm.nih.gov]

  Renal insufficiency is caused by PUVs in approximately 10-15% of children undergoing renal transplantation, and approximately one third of patients born with PUVs progress to end-stage renal disease (ESRD). [emedicine.com]

  Postnatal complications include: -pulmonary hypoplasia (a result of oligohydramnios) -renal insufficiency, either due to obstructive uropathy or renal dysplasia -urinary ascites (where high intraluminal pressure causes urine to extravasate from the kidneys [renalfellow.blogspot.com]

  A pediatric nephrologist is also following up the baby as some of these kids may have long term renal insufficiency. [pediatricurology.in]

• Kidney Failure

  bladder dysfunction renal function impairment and an increased risk of kidney failure vesicoureteral reflux (when urine flows backwards from the bladder up to the kidneys). [childrenshospital.org]

  Males with PUV have about a 20% chance of developing kidney failure over their lifetime. [choc.org]

  Some children, however, maintain preserved kidney function into adulthood, whereas others develop kidney failure in childhood ( 8 ). Previous reports suggested that nadir creatinine predicts the risk of kidney failure in children with PUV. [cjasn.asnjournals.org]

  Somehow his lungs formed enough for him to survive, but he was born with kidney failure. After over 4 years on dialysis and many surgeries, I was able to donate a kidney to him when he was 5. He is now almost 20 years old and doing great. [puvs.org]

• Dysuria

  He was acutely ill with suprapubic tenderness dysuria and poor urinary stream. He was hypertensive. Micturating cystourethrography showed posterior urethral valves and a bladder stone. [ncbi.nlm.nih.gov]

  Although rare, adult presentation of PUVs has been described in case reports, with symptoms ranging from obstructive voiding symptoms to postejaculatory dysuria. [emedicine.com]

  Case Report I.F. is a 9-year-old boy who presented with a chronic history of difficulty with micturition, dysuria, feeling of incomplete voiding, right loin pain, and recurrent fever, which was being managed in a peripheral clinic. [archintsurg.org]

• Renal Function Impairment

  function impairment and an increased risk of kidney failure vesicoureteral reflux (when urine flows backwards from the bladder up to the kidneys). [childrenshospital.org]

  Older infants and children usually have less renal function impairment and may present with a urinary tract infection or various voiding problems such as urgency, frequency or incontinence. [urologyweb.com]

• Nocturnal Enuresis

  PURPOSE: Endoscopic transurethral incision (TUI) of posterior urethral valve (PUV) can improve daytime urinary incontinence (DUI) and nocturnal enuresis (NE). However, the underlying mechanism has not been elucidated. [ncbi.nlm.nih.gov]

  Nocturnal enuresis, urinary frequency, and recurrent urinary tract infection [4] may also be present in mild long standing cases, as was noted in this index case. [archintsurg.org]

• Neonatal Urinary Ascites

  INTRODUCTION Ascites is a rare condition in neonates and generally may present several etiologies, urinary ascites being most frequently found(1,2). [rb.org.br]

• Hyponatremia

  MANAGEMENT Most neonates and young infants present with significant reduction in renal function and moderate degrees of acidosis, hyponatremia and dehydration. [urologyweb.com]

  The hyponatremia of neonatal urinary ascites: clinical observations, experimental confirmation and proposed mechanism. J Urol. 1993;150(2 Pt 2):778–81 1. [rb.org.br]

• Visceromegaly

  At clinical examination, the infant presented a significant abdominal distention, CASE REPORT but the abdomen was painless at palpation and apparently with no visceromegaly. Hydro-aerial bruits were present and the fluid-wave test was positive. [rb.org.br]

HUN resolved in 15 RUs and improved to a lower grade in 11 in 26 of the 27 RUs (96.3%) in the 17 patients compliant with treatment. The 3 boys (5 RUs) who were noncompliant with treatment had neither decreased HUN nor improved urodynamic parameters. [ncbi.nlm.nih.gov]

This determines the final prognosis, which is worse the younger the child at presentation. [ncbi.nlm.nih.gov]

A meta-analysis on the utility of vesicoamniotic drainage showed an improved overall perinatal survival versus the non-drainage group, especially in poor prognosis fetuses [8]. [degruyter.com]

Posterior urethral valve is found exclusively in males with an incidence of approximately 1 in 5000. [1] In 1919, Young et al. [4] first described PUV, and until the 1960s, it was reported to have an extremely poor prognosis. [archintsurg.org]

The overall prognosis is most affected by the degree and duration of obstruction. Severe cases with obstructive cystic renal dysplasia, oligohydramnios and pulmonary hypoplasia are often incompatible with life 2. [radiopaedia.org]

We have attempted to identify clearly the incidence, etiologic factors, preventive measures, and surgical treatment of complications arising in these patients. [ncbi.nlm.nih.gov]

EMBRYOLOGY OF POSTERIOR URETHRAL VALVES Three discrete embryologic defects are postulated in the etiology (1). The most common type (Type I in the Young classification). [fetalultrasound.com]

Unfortunately, there are a number of etiologies for this sonographic appearance, including urethral atresia, prune-belly syndrome, as well as PUV. [clinicalgate.com]

[…] congenital posterior urethral segment occlusion is caused by hypertrophy of the normal prostatic urethral valve because of incomplete differentiation of the terminal part of mesonephric ducts or of persistence of the urogenital membrane, however, the etiology [degruyter.com]

INTRODUCTION Ascites is a rare condition in neonates and generally may present several etiologies, urinary ascites being most frequently found(1,2). [rb.org.br]

Population-based normative data were provided by Perinatal and Reproductive Epidemiology Research Unit. [nature.com]

Epidemiology In the United States, PUV is the most common cause of lower urinary tract obstruction in male neonates; the reported incidence ranges from 1 per 8000 to 1 per 25,000 live births. [emedicine.com]

Original Articles Epidemiology and Outcomes CJASN March 2014, 9 (3) 499-505; DOI: https://doi.org/10.2215/CJN.08700813 This article requires a subscription to view the full text. [cjasn.asnjournals.org]

One involved the pathophysiology of posterior urethral valves (PUV), which came up in a clinical case. [renalfellow.blogspot.com]

Pathophysiology Posterior urethral valves can appear at the earliest stage of urinary tract development; therefore, the entire urinary tract develops in an abnormal environment of high intraluminal pressure due to the mechanical obstruction. [emedicine.com]

We have attempted to identify clearly the incidence, etiologic factors, preventive measures, and surgical treatment of complications arising in these patients. [ncbi.nlm.nih.gov]

Oligohydramnios prevents normal lung development in utero. Pathologically, this process results in reduced branching of the bronchial tree and reduced numbers and size of alveoli. [clinicalgate.com]

This extra tissue prevents the urethra from properly carrying urine from the bladder to the tip of the penis and out of the body. [childrenshospital.org]