Role of MCU in the Management of Posterior Urethral Valves

Objective: In infancy, the most common cause of bladder outlet obstruction is Posterior urethral valves (PUV), which impair renal and bladder function. This study was planned to evaluate and record the role of MCU in the various clinical presentations and management, complications, surgical management, and long-term outcomes of PUV. Methods: In this study, 49 patients treated for PUV were evaluated at the Bangladesh Shishu Hospital and Institute from May 2018 to April 2021. Complete data were taken, paraclinical examinations were performed on each patient, and the diagnosis was confirmed by micturating-cysto-urethrography (MCU). Posterior urethral valves were ablated in all patients using an electric hook. Results: A total of 49 patients with a mean age at diagnosis of 42(±21) days were included in this study. Catheterization was done within one to 5 days of life in 29 patients. PUV was ablated by an electric hook in all 49 patients. The most common symptoms in our group were dribbling, poor stream (71%), and urinary tract infection (UTI) (46%). There was vesico-ureteral-reflux (VUR) in 52% and hydronephrosis in 92.5%. The most common associated anomaly was kidney anomalies (Renal agenesis/dysplasia and multicystic kidney disease) in 4(8.2%) patients. About ten patients had prenatal diagnosis of PUV. Complications occurred in two (4.2%) patients. Mortality occurred in 3 (6.4%) patients. The mean follow-up period was 3.2±0.8 years (1.5 months to 4 years). Conclusion: MCU is the gold-standard imaging modality for documenting PUV and Postoperative follow-up to assess the condition of the posterior urethra urinary drainage by catheter in the early days of infancy. The factors like renal dysplasia and UTI have their role in the outcome.