The importance of re-look urethrocystoscopy after fulguration of posterior urethral valve

Background: Endoscopic fulguration is the gold-standard treatment for posterior urethral valve (PUV). However, there is no consensus on detecting residual valves post-fulguration. Some urologists advocate re-look urethrocystoscopy (UC), while others recommend voiding cystourethrograms (VCUG). This study evaluates the significance of re-look UC after initial PUV fulguration. Methods: This observational study involved 28 patients undergoing re-look UC post-fulguration due to persistent symptoms, elevated serum creatinine, or abnormalities in uroflowmetry and ultrasonography (e.g., high post-void residual (PVR) or hydroureteronephrosis). Continuous data were analyzed using the Wilcoxon signed-rank test and categorical data with Fischer’s exact test, with p<0.05 deemed significant. Results: The median age for re-look UC was 7 years. Symptoms included weak urinary stream (92.9%), straining (75%), dribbling (71.4%), and others. Hydroureteronephrosis was noted in 92.9% of cases, and 50% had elevated serum creatinine. Residual valves were detected in 21.4% of patients three months after initial fulguration. Residual PUV was associated with a higher median age of 10 years (p=0.045). No significant associations were found between residual PUV and hydroureteronephrosis, PVR, or serum creatinine levels. Conclusions: Re-look UC is crucial for detecting residual valves, enhancing clinical outcomes, and improving long-term bladder function. Integrating re-look UC into PUV management protocols is recommended to ensure comprehensive patient care.