Posterior urethral valve

As urethral valves ( PUV Syn ), posterior urethral valves english, one calls sail-like projections in the urethra ( urethra ) that ( colliculus seminals ) below the seed hill and obstruct the flow of urine. In extreme cases there is a complete obstruction of the urethra.

There are only affected boys of the malformation. It has a frequency of occurrence of 1:8000-1:25000.

Effects

By the obstruction in the urethra, the bladder must be increased to build up a pressure in order to drain the urine from the bladder to the outside. In the small extent flaps there is merely a thickened bladder wall. When pronounced it flaps in addition to a reflux of urine to the kidneys ( Vesikorenaler reflux ) with a corresponding damage should the same.

Prenatal kidney damage can lead to a reduced supply of amniotic fluid, which in turn leads to reduced lung growth. It comes in children with urethral valves thus more likely to miscarriage.

Diagnostics

Already prenatal ultrasound, the large fall in the urinary bladder with thickened bladder wall, if necessary extensions to the kidneys, ureters, or too little amniotic fluid volume on.

After birth, the children fall through a bad " stuttering " of urine, ultrasound also by a large bubble, thickened bladder wall and extensions to the kidneys and ureters on. The direct flap detection is sonographically also possible. At low expression of the flaps, children can later be noticed by trouble becoming dry or urinary tract infections.

The diagnosis is made because of the characteristic wall thickening with irregularities in the ultrasound and confirmed by voiding cystourethrogram.

Therapy

There are prenatal therapy experiments in which either is trying to destroy the flap, or relieve to term the bladder through a catheter introduced. So far, the results are moderate.

The urethral valves endoscopically or blown up ( with a knife, an electric hook or ) slotted with laser. Depending on the severity is primarily a derivative of the bladder by catheter necessary. Possibly several slits are necessary.

Forecast

The prognosis depends on the degree of obstruction and consequent renal injury from: Are changes before the 24th Schwangeswchaftswoche recognizable or the kidneys are altered in their echogenicity or have cysts on, the risk is increased that requires dialysis in childhood or adolescence will. Further complications are having trouble becoming dry, urinary incontinence, urinary tract infections, infections of the epididymis.