%0 Journal Article
%T Outcome of Late Presentation of Posterior Urethral Valves in a Resource-Limited Economy: Challenges in Management
%A Odutola Israel Odetunde
%A Oluwatoyin Arinola Odetunde
%A Adesoji Oludotun Ademuyiwa
%A Henrietta Uche Okafor
%A Uchenna Ekwochi
%A Jonathan Chukwuemeka Azubuike
%A Nene Elsie Obianyo
%J International Journal of Nephrology
%D 2012
%I Hindawi Publishing Corporation
%R 10.1155/2012/345298
%X Delayed presentation of patients with posterior urethral valve with complications like severe urosepsis, uremia, and anemia are seen in our setting. Renal replacement therapy which should have been offered to these patients is not readily available for children in our country. The aim of this study is to determine the pattern of late presentation and outcome of management of posterior urethral valve in a resource-limited setting. A descriptive retrospective study (1997每2009) was conducted. Data including pattern of presentation, duration of symptoms, complications, and outcome of initial management were analyzed. Twenty-one patients were seen. The median age was 3 years (2 days每13 years). The mean duration of symptoms before presentation was 2.6 years. Nineteen patients (91%) presented with urosepsis while 8 patients (36%) presented with significant renal insufficiency. Laboratory findings varied from-mild-to marked elevation in serum creatinine. Radiological findings confirmed the diagnosis of posterior urethral valve. We concluded that late presentation is common in our setting. This is associated with high morbidity and mortality rates. Efforts at improving awareness and early diagnosis among the health team should be made to stem the tide. 1. Introduction Posterior urethral valves (PUV) are the commonest cause of lower urinary tract obstruction in male infants [1每3]. The incidence of this congenital anomaly in our setting is unknown, although reports from Unites States and Europe indicates that it occurs in about 1ˋ:ˋ8000 and 1ˋ:ˋ25,000 male live births [1, 3, 4]. Prolonged and unrelieved lower urinary tract obstruction leads to back pressure effects on the kidneys resulting in obstructive uropathy with renal impairment [5]. PUVs are also a common cause of chronic renal failure in children if treatment is delayed [6每8]. Late presentation in patients with PUV is associated with urosepsis, uremia, and anemia and these form the bulk of patients seen in our centre. Early diagnosis and prompt commencement of treatment is therefore germane to the overall outcome of these patients [9, 10]. This is particularly important in a resource〞limited environment like ours where facilities for renal replacement therapy in children is not readily available. The aim of this study is to document the pattern of presentation in our centre and outcome of management. 2. Materials and Methods This is a retrospective descriptive study. Records of patients with PUV at the University of Nigeria Teaching Hospital (1997每2004) and Enugu State University of Technology Teaching
%U http://www.hindawi.com/journals/ijn/2012/345298/