Posterior urethral valves: clinical presentation and management approaches in a tertiary hospital in Sudan – a retrospective study

Posterior urethral valves (PUV) are the leading cause of lower urinary tract obstruction in male infants, often resulting in bladder outlet obstruction and potential renal damage. This study examines presentation patterns, diagnostic findings, and management strategies of PUV at a tertiary hospital in Sudan. A retrospective, descriptive cross-sectional study was conducted at Soba University Hospital over a five-year period, from January 2018 to December 2022. Data were collected from medical records of pediatric patients with confirmed (PUV) and analyzed using SPSS version 20. A total of 53 pediatric patients with confirmed PUV were included in the study. Patient ages ranged from birth to 11 years, with a median age of 7.2 months. Prenatal diagnosis was made in only 6 (11.3%) of cases. The most common presenting symptoms were poor urinary stream 42 (79.2%), fever 33 (62.3%), and pallor 15 (28.3%). Micturating cystourethrogram (MCUG) revealed a dilated posterior urethra in 50 (94.3%) of patients and vesicoureteral reflux (VUR) in 35 (66.0%). Elevated serum creatinine was observed in 42 (79.2%) of cases. Escherichia coli was the most frequently isolated organism 21 (53.8%) in urine cultures. Endoscopic valve ablation was the primary surgical intervention, performed in 37 (77.1%) of cases, while 11 (22.9%) underwent vesicostomy. The overall mortality rate was 3 (5.7%), mainly attributed to sepsis and pulmonary hypoplasia. Improving early diagnosis, timely referral, and access to pediatric urology services is critical in resource-limited settings. Strengthening prenatal screening and addressing surgical capacity gaps can enhance outcomes. Further studies should assess long-term renal and bladder function to inform future care.