|Year : 2001 | Volume
| Issue : 1 | Page : 84-85
Posterior urethral valves associated with urethral calculi
Arvind Sinha, Yogesh Kumar Sarin, Mamta Sagar
Department of Paediatric Surgery, Maulana Azad Medical College and Associated LN Hospital, New Delhi., India
Yogesh Kumar Sarin
Department of Paediatric Surgery, Maulana Azad Medical College and Associated LN Hospital, New Delhi 110002
Source of Support: None, Conflict of Interest: None
Keywords: Posterior Urethral Valves; Urethral Calculi.
|How to cite this article:|
Sinha A, Sarin YK, Sagar M. Posterior urethral valves associated with urethral calculi. Indian J Urol 2001;18:84-5
| Introduction|| |
Posterior urethral valves is a common cause of urethral obstruction in male child. The association of these valves with bladder or urethral calculi is not very common with only a handful of reports of such an association. We present one such case.
| Case Report|| |
A 6-year-old boy presented with urinary retention for a day; he had been having difficulty in passing urine and occasional dribbling of urine since one year. There was no previous history of retention of urine or of any instrumentation of the urinary tract. On examination the bladder was palpable up to the umbilicus. The roentengenogram of the kidney, ureter and the bladder region (KUB) showed a bilobed stone impacted in the region of the urethra and the bladder neck [Figure - 1]. The renal function tests were normal. Urethral catheterization was unsuccessfully tried. The patient was taken up for an emergency suprapubic cystolithotomy. The bladder was thick walled and dilated and the stone was found to be impacted in the posterior urethra and the bladder neck. The stone was extracted through the bladder [Figure - 2]. The child was discharged on fourth post-operative day.
The patient however continued to have urinary symptoms on follow-up. The urine culture was sterile. The patient was taken up for ureterocystoscopy which revealed type I posterior urethral valves: the valves were fulgurated. Since then, the patient has been passing urine in a good stream. Post-operatively, a micturating cystography was performed which did not document any vesico-ureteral reflux or bladder abnormality. A check ureterocystoscopy performed 6 weeks later revealed no residual urethral valves.
| Discussion|| |
Posterior urethral valves usually present with bed wetting, urinary infection, poor stream, frequency, dribbling, hematuria and acute urinary retention. Although posterior urethral valves is a well-known and important entity in pediatric urology, its association with bladder and urethral calculi is not well documented and this condition is not discussed commonly in literature. Only a few ases of posterior valves associated with bladder and prostratic calculi have been reported in literature., This association of the calculi with posterior urethral valves can lead to a delay in the diagnosis of the posterior urethral valves. The diagnosis of posterior urethral valves should be suspected in all children with vesical or urethral calculi who have persistence of symptoms even after the removal of the calculi.
| References|| |
|1.||Hendren WH. Posterior urethral valves in boys: A broad clinical spectrum. J Urol 1971: 106: 298-307. |
|2.||Neulander E. Kaneb J. Posterior urethral valves and vesicolithiasis in children. Lu Urol Nephrol 1996: 28: 563-568. |
|3.||Mallouh C. Urethral valves: unusual presentation in a 14-year-old boy. Int Urol Nephrol 1993; 25: 235-237 |
[Figure - 1], [Figure - 2]