Departmennt of Surgery and Subspecialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon.
Paediatric Surgery Unit, Yaoundé Gynaeco-Obstetric and Paediatric Hospital, Yaoundé, Cameroon.
BMC Urol. 2018 May 21;18(1):46. doi: 10.1186/s12894-018-0364-1.
The incidence of posterior urethral valve (PUV) is estimated at 1:5000-1:8000 males. It is the most common paediatric urologic urgency and the most common cause of male obstructive uropathy and chronic renal failure in children. The study aimed to describe the experience of Yaoundé gynaeco-obstetrics and paediatric hospital in the management of PUV.
Retrospectively, medical records were retrieved over a ten year period and all data recorded and analyzed for study objectives. Patients were called and evaluated for outcomes regarding morbidity and mortality.
A total of 18 patients all males were managed over the ten year period, given prevalence of 13 cases/100,000 admissions and an admission rate of 2 per annum. The median age at presentation was 22 months and 13 (72.2%) participants presented late. Voiding urethrocystogram was done in all the participants where it showed dilated and elongated posterior urethral valves in 16 (88.9%) of the cases. Endoscopic valve ablation resulted in the relief of obstruction in all but 3 (16.7%) participants that had residual valves and 2 (11.2%) participants that had urethral stenosis. Type I valves were most common in 14 (78.0%) participants. The mean duration of follow up was 34.56 ± 21.47 months. Complications at final follow up were: 10 (55.6%) chronic renal failure, 2 (11.2%) end-stage renal failure. The case fatality rate was 5.6%.
Many patients present late in our setting with already established complications. There is the need to counsel parents/guardians on the importance of long-term follow up after relief of obstruction.
后尿道瓣膜（PUV）的发病率估计为每 5000-8000 名男性中有 1 例。它是小儿泌尿科最常见的急症，也是儿童男性梗阻性尿路病和慢性肾衰竭最常见的原因。本研究旨在描述雅温得妇科-产科和儿科医院在 PUV 管理方面的经验。
回顾性地，在十年期间检索了病历，并记录和分析了所有数据以实现研究目标。对患者进行了随访，以评估发病率和死亡率方面的结果。
在十年期间共管理了 18 名男性患者，患病率为 13 例/100,000 例入院，入院率为 2 例/年。中位就诊年龄为 22 个月，13 名（72.2%）患者就诊较晚。所有患者均进行了排尿性尿道膀胱造影，其中 16 例（88.9%）患者的后尿道瓣膜扩张和延长。内镜下瓣膜消融术使所有患者梗阻得到缓解，但有 3 例（16.7%）患者仍有残留瓣膜，2 例（11.2%）患者有尿道狭窄。14 名（78.0%）患者的瓣膜类型为 I 型。平均随访时间为 34.56±21.47 个月。最终随访时的并发症有：10 例（55.6%）慢性肾衰竭，2 例（11.2%）终末期肾衰竭。病死率为 5.6%。
在我们的环境中，许多患者就诊较晚，已经存在已建立的并发症。需要向父母/监护人告知梗阻解除后长期随访的重要性。
