Current Trends In Medical And Clinical Case Reports

Presentation and early Surgical outcome in the late presenting posterior urethral valve at Kilimanjaro Christian Medical Centre-Tanzania

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: [email protected]


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.




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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