A review of cases of posterior urethral valves seen at the University College Hospital, Ibadan (Nigeria).

A cohort of 40 male children with Posterior Urethral Valves (PUV) seen in the Paediatric Nephrology/Urology Unit of the University College Hospital, Ibadan are presented. They were reviewed with the aim of determining the clinical course of the disease in a developing country where the facilities for active intervention are not always available. Even though 50% of the patients became symptomatic in the first week of life only 22.5% presented in the whole of the neonatal period. Thirty-seven and a half per-cent (37.5%) presented in the post-neonatal infancy period and the rest beond the first year of life. The interval between the onset of symptoms and definitive therapy was up to three years in some patients. Only 2 patients had antenatal diagnosis of the PUV by ultrasonography. The major renal complications were: (1) Urinary Tract Infections in 40%; (2) Acute Renal failure--10%; (3) Chronic Renal failure--7%; 4) Type IV Renal Tubular Acidosis--10% (5) Sustained hypertension--4.8%. The extra-renal complications were anaemia (30%), malnutrition (10%). Five of the patients died giving a case fatality rate of 12.5%, mainly from overwhelming infections and renal failure. Many of our patients had delayed presentation even though symptomatic and that may partly explain the complications and the poor outcome seen in the short term.