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Frank Chacha, J.S. Mbwambo, Frank Bright, K.A.
Mteta
Kilimanjaro Christian Medical University
College, Tanzania
*Corresponding
Author: Frank Chacha, Kilimanjaro Christian
Medical University College, Tanzania, E-mail Id: frank888990@gmail.com
Citation: Frank Chacha (2020) Late Diagnosis and Poor Treatment of Posterior
Urethra Valve From Kilimanjaro Christian Medical Cente, Tanzania.
Current Trends Med Clin Case Rep, 1(1); 1-7
Copyright: © 2020, Chacha F, This is an open-access article distributed
under the terms of the Creative Commons Attribution 4.0 International License,
which permits unrestricted use, distribution and reproduction in any medium,
provided the original author and source are credited.
ABSTRACT
Background: Posterior urethra valve is one of the few
urological condition that require early diagnosis during antennal life and
early antenatal intervention. Miss diagnosis or delay in treatment would leads
to progressive renal deterioration and finally end stage hydronephrosis. The
objective of the study is to determine presentation and early surgical outcome
of late presenting PUV among children seen at KCMC from January 2008 to October
2015.
Methodology: This was a descriptive cross-sectional
hospital based study. It involved patients presented in the Institute of
Urology at KCMC confirmed to have PUV, and operated during the period of study
from January 2008 to October 2015.
Results: A total number of 104 cases were diagnosed and
treated for PUV. Of 57 (78%) cases of study participants had pre-operation
Serum creatinine tested, and was found to be high in 11 (19.3%) of the
patients. 18 (24.7%) were found to have vesical ureteric reflux, more common
grade were grade 7 and 5, in about 7 (38.9%) and 5 (27.8%) respectively.
Initial treatment was given included vesicostomy 29 (39.7) and
catheterization 5 (6.9%), 56 (76.7%) underwent definitive surgical treatment
(valve ablation) in which 38 (67.9) had electrofulgration and 18 (32.1%) had
cold knife. Typical type I PUV were observed in 55 (98.2%), and only 1 patient
had had type III. 28 (67.7%) of 56 patients after valve ablation in 6 months
follow up period had good voiding urine stream. Surgical complications noted
were urethral stricture 1(2.4%) patient, residual valve 3 (7.5%) patients and
urinary incontinence in 2 (4.9%) patients, in which all were from the age group
of 12 to 60 months. Post vesicostomy was initial treatment, 3 (10.3%) had
vesicostomy stenosis, 1 (3.4%) bladder prolapse and 2 (6.9%) died. Cold knife
have lesser complications when compared to electrofulgration in which 2 (7.4%)
had residual valve, 2 (7.4%) had urethral stricture and one (3.7%) developed
urine incontinence after electrofulgration.
Conclusion:
A significant number of PUV patients whom are seeing at KCMC present late with
complications of the disease. Most prevalent age group was 13 to 60 months this
may be attributed by a delay in referrals.
KEYWORD: Pediatric
Urology, Posterior Urethra Valve, Surgical Outcome
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