Delayed presentation of posterior urethral valves: A not so benign condition

M. David Bomalaski, John G. Anema, Douglas E. Coplen, Harry P. Koo, Thomas A Rozanski, David A. Bloom

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

Purpose: Posterior urethral valves are usually detected during infancy by prenatal sonography. Rarely they may be diagnosed during later childhood, adolescence or even adulthood. Less is known about presentation and outcome in these older patients. We reviewed our experience at 4 institutions with the late presentation of posterior urethral valves. Materials and Methods: A 13-year retrospective review revealed the late presentation of posterior urethral valves in 47 patients 5 to 35 years old (mean age 8). Data collected included presenting symptomatology, radiographic findings and renal function. Statistical analysis determined the relationships among presenting symptoms, patient age at diagnosis and renal function. Results: The most common presenting symptoms were diurnal enuresis in 60% of the cases, urinary tract infection in 40% and voiding pain in 13%. Other presenting symptoms in less than 10% of the cases included poor stream, gross hematuria and proteinuria. At diagnosis hydronephrosis and vesicoureteral reflux were present in 40 and 33% of the patients, respectively, while serum creatinine was elevated in 35% and end stage renal disease had developed in 10%. The severity of presenting signs and symptoms was significantly associated with renal impairment, while patient age at diagnosis was not. Conclusions: Posterior urethral valves is not merely a disease of infancy. Voiding cystourethrography should be considered in boys older than 5 years who have voiding complaints, especially in association with diurnal enuresis or urinary tract infection. Patients who present late with posterior urethral valves are at risk for progression to end stage renal disease.

Original languageEnglish (US)
Pages (from-to)2130-2132
Number of pages3
JournalJournal of Urology
Volume162
Issue number6
StatePublished - Dec 1999
Externally publishedYes

Fingerprint

Diurnal Enuresis
Kidney
Urinary Tract Infections
Chronic Kidney Failure
Prenatal Ultrasonography
Vesico-Ureteral Reflux
Hydronephrosis
Hematuria
Proteinuria
Signs and Symptoms
Creatinine
Pain
Serum

Keywords

  • Abnormalities
  • Chronic
  • Enuresis
  • Kidney failure
  • Urethra
  • Urinary tract infections

ASJC Scopus subject areas

  • Urology

Cite this

Bomalaski, M. D., Anema, J. G., Coplen, D. E., Koo, H. P., Rozanski, T. A., & Bloom, D. A. (1999). Delayed presentation of posterior urethral valves: A not so benign condition. Journal of Urology, 162(6), 2130-2132.

Delayed presentation of posterior urethral valves : A not so benign condition. / Bomalaski, M. David; Anema, John G.; Coplen, Douglas E.; Koo, Harry P.; Rozanski, Thomas A; Bloom, David A.

In: Journal of Urology, Vol. 162, No. 6, 12.1999, p. 2130-2132.

Research output: Contribution to journalArticle

Bomalaski, MD, Anema, JG, Coplen, DE, Koo, HP, Rozanski, TA & Bloom, DA 1999, 'Delayed presentation of posterior urethral valves: A not so benign condition', Journal of Urology, vol. 162, no. 6, pp. 2130-2132.
Bomalaski MD, Anema JG, Coplen DE, Koo HP, Rozanski TA, Bloom DA. Delayed presentation of posterior urethral valves: A not so benign condition. Journal of Urology. 1999 Dec;162(6):2130-2132.
Bomalaski, M. David ; Anema, John G. ; Coplen, Douglas E. ; Koo, Harry P. ; Rozanski, Thomas A ; Bloom, David A. / Delayed presentation of posterior urethral valves : A not so benign condition. In: Journal of Urology. 1999 ; Vol. 162, No. 6. pp. 2130-2132.
@article{bb601a34bf8949af93da1e8ba2803ef9,
title = "Delayed presentation of posterior urethral valves: A not so benign condition",
abstract = "Purpose: Posterior urethral valves are usually detected during infancy by prenatal sonography. Rarely they may be diagnosed during later childhood, adolescence or even adulthood. Less is known about presentation and outcome in these older patients. We reviewed our experience at 4 institutions with the late presentation of posterior urethral valves. Materials and Methods: A 13-year retrospective review revealed the late presentation of posterior urethral valves in 47 patients 5 to 35 years old (mean age 8). Data collected included presenting symptomatology, radiographic findings and renal function. Statistical analysis determined the relationships among presenting symptoms, patient age at diagnosis and renal function. Results: The most common presenting symptoms were diurnal enuresis in 60{\%} of the cases, urinary tract infection in 40{\%} and voiding pain in 13{\%}. Other presenting symptoms in less than 10{\%} of the cases included poor stream, gross hematuria and proteinuria. At diagnosis hydronephrosis and vesicoureteral reflux were present in 40 and 33{\%} of the patients, respectively, while serum creatinine was elevated in 35{\%} and end stage renal disease had developed in 10{\%}. The severity of presenting signs and symptoms was significantly associated with renal impairment, while patient age at diagnosis was not. Conclusions: Posterior urethral valves is not merely a disease of infancy. Voiding cystourethrography should be considered in boys older than 5 years who have voiding complaints, especially in association with diurnal enuresis or urinary tract infection. Patients who present late with posterior urethral valves are at risk for progression to end stage renal disease.",
keywords = "Abnormalities, Chronic, Enuresis, Kidney failure, Urethra, Urinary tract infections",
author = "Bomalaski, {M. David} and Anema, {John G.} and Coplen, {Douglas E.} and Koo, {Harry P.} and Rozanski, {Thomas A} and Bloom, {David A.}",
year = "1999",
month = "12",
language = "English (US)",
volume = "162",
pages = "2130--2132",
journal = "Journal of Urology",
issn = "0022-5347",
publisher = "Elsevier Inc.",
number = "6",

}

TY - JOUR

T1 - Delayed presentation of posterior urethral valves

T2 - A not so benign condition

AU - Bomalaski, M. David

AU - Anema, John G.

AU - Coplen, Douglas E.

AU - Koo, Harry P.

AU - Rozanski, Thomas A

AU - Bloom, David A.

PY - 1999/12

Y1 - 1999/12

N2 - Purpose: Posterior urethral valves are usually detected during infancy by prenatal sonography. Rarely they may be diagnosed during later childhood, adolescence or even adulthood. Less is known about presentation and outcome in these older patients. We reviewed our experience at 4 institutions with the late presentation of posterior urethral valves. Materials and Methods: A 13-year retrospective review revealed the late presentation of posterior urethral valves in 47 patients 5 to 35 years old (mean age 8). Data collected included presenting symptomatology, radiographic findings and renal function. Statistical analysis determined the relationships among presenting symptoms, patient age at diagnosis and renal function. Results: The most common presenting symptoms were diurnal enuresis in 60% of the cases, urinary tract infection in 40% and voiding pain in 13%. Other presenting symptoms in less than 10% of the cases included poor stream, gross hematuria and proteinuria. At diagnosis hydronephrosis and vesicoureteral reflux were present in 40 and 33% of the patients, respectively, while serum creatinine was elevated in 35% and end stage renal disease had developed in 10%. The severity of presenting signs and symptoms was significantly associated with renal impairment, while patient age at diagnosis was not. Conclusions: Posterior urethral valves is not merely a disease of infancy. Voiding cystourethrography should be considered in boys older than 5 years who have voiding complaints, especially in association with diurnal enuresis or urinary tract infection. Patients who present late with posterior urethral valves are at risk for progression to end stage renal disease.

AB - Purpose: Posterior urethral valves are usually detected during infancy by prenatal sonography. Rarely they may be diagnosed during later childhood, adolescence or even adulthood. Less is known about presentation and outcome in these older patients. We reviewed our experience at 4 institutions with the late presentation of posterior urethral valves. Materials and Methods: A 13-year retrospective review revealed the late presentation of posterior urethral valves in 47 patients 5 to 35 years old (mean age 8). Data collected included presenting symptomatology, radiographic findings and renal function. Statistical analysis determined the relationships among presenting symptoms, patient age at diagnosis and renal function. Results: The most common presenting symptoms were diurnal enuresis in 60% of the cases, urinary tract infection in 40% and voiding pain in 13%. Other presenting symptoms in less than 10% of the cases included poor stream, gross hematuria and proteinuria. At diagnosis hydronephrosis and vesicoureteral reflux were present in 40 and 33% of the patients, respectively, while serum creatinine was elevated in 35% and end stage renal disease had developed in 10%. The severity of presenting signs and symptoms was significantly associated with renal impairment, while patient age at diagnosis was not. Conclusions: Posterior urethral valves is not merely a disease of infancy. Voiding cystourethrography should be considered in boys older than 5 years who have voiding complaints, especially in association with diurnal enuresis or urinary tract infection. Patients who present late with posterior urethral valves are at risk for progression to end stage renal disease.

KW - Abnormalities

KW - Chronic

KW - Enuresis

KW - Kidney failure

KW - Urethra

KW - Urinary tract infections

UR - http://www.scopus.com/inward/record.url?scp=0032702308&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0032702308&partnerID=8YFLogxK

M3 - Article

C2 - 10569602

AN - SCOPUS:0032702308

VL - 162

SP - 2130

EP - 2132

JO - Journal of Urology

JF - Journal of Urology

SN - 0022-5347

IS - 6

ER -