Congenital urethral valves

Congenital valves of the urethra are relatively common in boys (1:50,000 newborns) and extremely rare in girls, and are characterized by the presence of membranes (folds), both sides of which are covered with a mucous membrane.

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Symptoms congenital urethral valves.

Despite the different types of valves, the clinical symptoms of congenital urethral valves are similar. This disease is characterized by the same symptoms as congenital sclerosis of the bladder neck. However, the severity of clinical symptoms depends on the degree of obstruction and the age of the patients. With severe obstruction, clinical symptoms are recorded already in the first years of a child's life, when ureterohydronephrosis is diagnosed; at an older age, the clinical picture of a urinary infection comes to the fore. Sometimes enuresis and daytime urinary incontinence are noted.

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Forms

There are three types of urethral valves:

• Type 1: a cup-shaped valve (most common), located below the seminal tubercle:
• Type 2: funnel-shaped valves (usually multiple), extending from the seminal tubercle to the neck of the bladder;
• 3rd type: valves in the form of a transverse diaphragm located above or below the seminal tubercle.

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Diagnostics congenital urethral valves.

Unlike congenital sclerosis of the bladder neck, with urethral valves, bougies, catheters and cystoscopes pass freely into the bladder. If there is a valve, when removing the glans bougie from the bladder, an obstruction is felt at the level of the back. During urethroscopy, valves are detected at this level

Urethrocystograms show an enlarged bladder: its neck is open, dilated, the back part above the valve is dilated in the form of a sac or funnel, the distal part is of normal diameter. At the valve level, there is an "hourglass" symptom. At later stages, diverticula and vesicoureteral reflux are detected.

UFM, profilometry and cystomanometry reveal not only the disturbance of the rate of urination, but also the localization of obstruction.

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Treatment congenital urethral valves.

Congenital urethral valves are treated surgically using endourethral resection of the mucous membrane along with the valve.