Management of posterior urethral valves in rural Kenya

Background: Posterior Urethral Valves (PUV) are the most common cause of bladder outlet obstruction in children. Early detection is necessary to prevent potentially irreversible sequel. We conducted a study to determine the presentation, interventions and outcome of patients with PUV. Methods: A retrospective study was conducted over a six year period with an average of two years follow-up. Results: The commonest presenting symptoms were dysuria (55%), poor urinary stream(67%)and straining (39%). Malnutrition was present in 36%. Four patients developed chronic renal failure. There were four mortalities due to urosepsis, acute renal failure, and complications of Mainz-II ureterosigmoidostomy. 40% of patients developed valve bladder syndrome. Conclusion: The high incidence of valve bladder indicates delayed intervention even when addressed in the early postnatal period. This, coupled with malnutrition call for a multidisciplinary approach and long term follow up of these patients.