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Anterior urethral valves in children: an uncommon multipathogenic cause of obstructive uropathy

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Abstract

Introduction

Anterior urethral valves (AUVs) are uncommon congenital anomalies causing urethral obstruction in boys.

Patients and methods

Medical records of 13 children were reviewed retrospectively. Each patient (pt) was evaluated with voiding cysto-urethrogram (VCUG) and renal ultrasonography. Pts older than 5 years performed an uroflowmetry. Serum creatine was determined in all children.

Results

All pts had difficulty in voiding and eight had recurrent urinary tract infection. Renal function was normal in all pts. VCUG showed filling of Cowper’s duct in a pt. In a case, a vesicoureteral reflux was discovered. Uroflowmetry showed a flat trace in all cases. Transurethral endoscopic resection of the valves was carried out in 11 children while open resection was necessary in two children. At serial follow-up, all pts remain symptom-free and uroflowmetry documented regular pattern.

Discussion

Anterior urethral valves are rare lesions that may create problems at different stages. Some AUVs may result from the obstruction distal lip of a ruptured syringocele. Improvements in endoscopic equipment allow for minimally invasive transurethral resection. Large diverticula are best managed with open diverticulectomy and reconstruction. In newborns with severe altered urinary tract drainage, particularly in low birth-weight infant, a vesicostomy may be necessary.

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Authors and Affiliations

  1. Unit of Pediatric Surgery, Department of Pediatric Surgery, University of Catania, Catania, Italy

    Salvatore Arena & Vincenzo Di Benedetto

  2. Unit of Pediatric Surgery, Department of Medical and Surgical Pediatric Sciences, University of Messina, Policlinico, Viale Gazzi, 98125, Messina, Italy

    Carmelo Romeo, Francesca Astra Borruto & Francesco Arena

  3. Unit of Radiology, Department of Radiology, University of Messina, Messina, Italy

    Sergio Racchiusa

Authors
  1. Salvatore Arena
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  2. Carmelo Romeo
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  3. Francesca Astra Borruto
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  4. Sergio Racchiusa
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  5. Vincenzo Di Benedetto
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  6. Francesco Arena
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Corresponding author

Correspondence to Francesco Arena.

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Arena, S., Romeo, C., Borruto, F.A. et al. Anterior urethral valves in children: an uncommon multipathogenic cause of obstructive uropathy. Pediatr Surg Int 25, 613–616 (2009). https://doi.org/10.1007/s00383-009-2393-z

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  • DOI: https://doi.org/10.1007/s00383-009-2393-z

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