Kibar Yusuf, Coban Hidayet, Irkilata H Cem, Erdemir Fikret, Seckin Bedrettin, Dayanc Murat
Gulhane Military Medical Academy, Department of Urology, 06018 Etlik, Ankara, Turkey.
J Pediatr Urol. 2007 Oct;3(5):350-3. doi: 10.1016/j.jpurol.2007.01.197. Epub 2007 Mar 28.
Anterior urethral valves (AUV) are rare entities generally described in case reports. They are an uncommon cause of lower urinary tract obstruction in children and can be difficult to diagnose. In the present study, we present our experience in four children with AUV along with a literature review.
We retrospectively identified four children with AUV presented between 1998 and 2005 at age 4-9 years.
Hematuria, urinary tract infection and weak voiding stream were the most common symptoms. Voiding cystourethrography (VCUG) confirmed the diagnosis of AUV. On cystourethroscopy, cusp-like valves in the anterior urethra were seen in all children. Transurethral endoscopic resection of the valves was carried out in three children using a pediatric resectoscope. In one child with a massive anterior urethral diverticulum, open resection of the valve, diverticulectomy and urethroplasty were performed. All patients were cured, none had complications as a result of surgery, and all reported a normal urinary stream at follow-up.
Children with poor stream and recurrent infections should be evaluated carefully and anterior urethral valves should be considered in differential diagnosis of obstructive lesions.
前尿道瓣膜（AUV）较为罕见，通常在病例报告中有所描述。它们是儿童下尿路梗阻的少见原因，且可能难以诊断。在本研究中，我们介绍了4例AUV患儿的诊疗经验并进行文献复习。
我们回顾性分析了1998年至2005年间就诊的4例年龄在4至9岁的AUV患儿。
血尿、尿路感染和排尿无力是最常见的症状。排尿性膀胱尿道造影（VCUG）确诊为AUV。膀胱尿道镜检查时，所有患儿均可见前尿道有瓣状瓣膜。3例患儿使用小儿电切镜行经尿道内镜瓣膜切除术。1例患有巨大前尿道憩室的患儿，行瓣膜开放切除术、憩室切除术及尿道成形术。所有患者均治愈，无手术相关并发症，随访时均报告尿流正常。
对于尿流不畅和反复感染的儿童应仔细评估，在梗阻性病变的鉴别诊断中应考虑前尿道瓣膜。
