Melekos M D, Asbach H W, Giannoulis S, Perimenis P, Barbalias G
Department of Urology, Patras University School of Medicine, Rio-Patras, Greece.
Int Urol Nephrol. 1989;21(1):57-62. doi: 10.1007/BF02549902.
Twenty-six boys were evaluated and treated for posterior urethral valves. At the time the valves were diagnosed unilateral or bilateral vesicoureteral reflux was present in 58% of the ureters and 69% of the children, while dilatation of the upper urinary tract was present in 88% and 92%, respectively. There was a variety of symptoms and signs, but the most prominent in neonates and infants were vesical urine retention, palpable kidneys and failure to thrive, whereas in the older children voiding dysfunction, incontinence and urinary infection were the most common. Twenty-four out of 26 boys were managed by primary valve ablation and in 62.5% of them this type of treatment was adequate in resolving or sufficiently improving clinical manifestations and roentgenologic findings, requiring no further management. Urinary diversion in the form of vesicostomy and cutaneous ureterostomy was preserved for those patients who did not improve with valve ablation alone. The current aspects concerning posterior urethral valves are also discussed.
对26名患有后尿道瓣膜的男孩进行了评估和治疗。在诊断出瓣膜时，58%的输尿管和69%的儿童存在单侧或双侧膀胱输尿管反流，而上尿路扩张分别出现在88%和92%的病例中。症状和体征多种多样，但在新生儿和婴儿中最突出的是膀胱尿潴留、可触及的肾脏和发育不良，而在较大儿童中，排尿功能障碍、尿失禁和泌尿系统感染最为常见。26名男孩中有24名接受了原发性瓣膜切除术，其中62.5%的患儿通过这种治疗方式足以解决或充分改善临床表现和影像学检查结果，无需进一步治疗。对于仅行瓣膜切除术效果不佳的患者，则采用膀胱造口术和皮肤输尿管造口术等尿流改道术。本文还讨论了后尿道瓣膜的当前相关问题。
