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The Zero to Finals Medical Revision Podcast

Posterior Urethral Valve

The Zero to Finals Medical Revision Podcast

Thomas Watchman

Life Sciences, Education, Medical Finals, Medicine, Surgery, Health & Fitness, Paediatrics, Medical Student, Medical Education, Medical Exams, Medical School, Medical Revision, Science, Learn Medicine, Finals Revision, Obstetrics And Gynaecology

4.8678 Ratings

🗓️ 10 August 2020

⏱️ 3 minutes

🧾️ Download transcript

Summary

This episode covers posterior urethral valve. Written notes can be found at https://zerotofinals.com/paediatrics/renal/puv/ or in the renal and urology section in the Zero to Finals paediatrics book. The audio in the episode was expertly edited by Harry Watchman.

Transcript

Click on a timestamp to play from that location

0:00.0

Hello and welcome to the Zero to Finals podcast. My name is Tom and in this episode I'm going to be

0:08.3

talking to you about posterior urethral valves. And if you want to follow along with written notes on this

0:13.8

topic, you can follow along at zero tofinals.com slash puv or in the renal and urology section of the zero definals pediatrics book.

0:24.2

So let's get straight into it.

0:26.4

A posterior urethral valve is where there is tissue at the proximal end of the urethra,

0:32.0

closest to the bladder that causes obstruction of urine outflow.

0:37.2

It occurs in newborn boys.

0:39.7

The obstruction to the outflow of urine creates a back pressure into the bladder,

0:44.3

uritus and up to the kidneys, causing hydronephrosis.

0:49.9

A restriction in the outflow of urine prevents the bladder from fully emptying,

0:54.4

which leaves a reservoir of urine that increases the risk of urinary tract infections.

1:00.4

Let's talk about the presentation.

1:03.2

It can vary in severity, mild cases may be asymptomatic,

1:08.2

and more significant cases can present with difficulty urinating, weak urinary stream,

1:15.1

chronic urinary retention, a palpable bladder on examination, recurrent urinary tract infections

1:22.8

and impaired kidney function. Severe cases can cause obstruction to urine outflow in the developing fetus,

1:31.5

and this results in bilateral hydronephrosis and oligohydramneous,

1:36.7

which is a low level of amniotic fluid.

1:40.0

The oligohydramneous leads to underdeveloped fetal lungs,

1:43.7

which we call pulmonary hypoplasia

1:46.0

with respiratory failure shortly after birth.

1:49.0

Let's talk about the investigations.

...

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