4.8 • 678 Ratings
🗓️ 10 August 2020
⏱️ 3 minutes
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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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