Anterior urethral valves: A rare cause of infravesical obstruction in children

Purpose: The aim of this study was to report the clinical presentation, mode of diagnosis, and treatment of patients with anterior urethral valves (AUV), a rare congenital anomaly causing infravesical obstruction in children. Methods: Three patients with anterior urethral valves were admitted in the Pediatric Urology Unit at The Children's Hospital, Lahore, Pakistan, during the period 1997 through 1998. Main clinical features included difficulty in voiding, dribbling of urine, incontinence, poor urinary stream, hematuria, and urinary tract infections. The diagnosis was confirmed by voiding cysto-urethrogram (VCUG) in 2 patients and retrograde urethrogram in 1 patient. A total of 4 valves were found; 1 patient had 2 valves. Two patients had associated vesico-ureteric reflux. Endoscopic resection was performed in all patients. Results: Postoperatively, all patients were able to pass urine with good stream. At 9 to 24 months' follow-up, all patients remain well and asymptomatic. Conclusions: Although rare, AUV must be considered in the differential diagnosis of lower urinary tract obstruction. They present with all degrees of severity depending on the age of patient and the degree of obstruction. A properly performed and carefully interpreted VCUG is essential for diagnosis. Transurethral resection is the treatment of choice. J Pediatr Surg 35:556-558. Copyright © 2000 by W.B. Saunders Company.