Congenital valves of the urethra

Congenital urethral valves are relatively common in boys (1:50 000 newborns) and very rarely in girls, is the presence of membranes (folds), both sides of which are covered with mucous membranes.

[1], [2], [3], [4], [5], [6]

Symptoms of the congenital urethral valves

Despite the different types of valves, the clinical symptoms of congenital urethral valves are the same. This disease is characterized by the same symptoms as for congenital sclerosis of the neck of the bladder. 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 there is enuresis and flu incontinence.

[7], [8], [9], [10]

Forms

There are three types of valves of the urethra:

• Type 1: a valve having a cup-like shape (found most often) located below the seed tubercle:
• 2nd type: funnel-shaped valves (more often multiple), extending from the seminal tubercle to the neck of the bladder;
• Type 3: valves in the form of a transverse diaphragm, located above or below the seminal tubercle.

[11], [12], [13],

Diagnostics of the congenital urethral valves

Unlike congenital sclerosis of the neck of the bladder, with valves of the urethra, bougies, catheters and cystoscopes pass freely into the bladder. If there is a valve, when removing the head bougie from the bladder, an obstacle is felt at the level of the rear part. With urethroscopy, valves are found at this level

On the urethrocystograms, the bladder enlargement is detected, its neck is open, expanded, the posterior part above the valve is widened in the form of a sac or funnel, the distal section is of the usual diameter. At the valve level - a symptom of "hourglass." In later terms, diverticulum and vesicoureteral reflux are revealed.

With UFM, profilometry and cystomanometry, not only a violation of the rate of urination, but also the localization of obstruction.

[14], [15], [16], [17]

Treatment of the congenital urethral valves

The congenital valves of the urethra are surgically treated with endourethral resection of the mucous membrane along with the valve.