Posterior urethral valves: a report based on 10 patients.

Bladder outflow obstruction is a well recognised problem in the newborn, infants and children. In Pakistan a large number of these patients suffer from stone in the urinary bladder which are treated by vesicolithotomy. However a group develops outflow obstruction due to a number of other causes and posterior urethral valves in the male is one such cause. Posterior urethral valves are congenital mucosal folds originating at the distal end of verumontanum extending obliquely on either side of the prostatic urethra. Developmental anatomv has been a controversial subject (Young, 1972). Functionally these are one way valves producing varying degrees of outflow obstruction with understandable devastating clinical implications. These valves were first described by Young et al (1919). Their original observations were based on 5 postmortem cases and the types described by them are not valid today. Since their description posterior urethral valves were considered as rare entities. Marion's disease was thought to be the main cause of bladder outflow obstruction. With the introduction of wide angle fiber optics Marion's disease is rarely diagnosed and valves are considered to be the commonest form of outflow obstruction in children (Williams, 1968). In Pakistan our attention was drawn to the urinary problems of pediatric age group when we acquired the pediatric fiber optic resectoscope. In this paper we shall highlight the problems of management of patients with posterior urethral valves in Pakistani setting. A plea for early recognition and treatment has been made.