Posterior urethral valve (PUV) disorder is an obstructive developmental anomaly in the urethra and genitourinary system of male newborns. A posterior urethral valve is an obstructing membrane in the posterior male urethra as a result of abnormal in utero development. It is the most common cause of bladder outlet obstruction in male newborns. The disorder varies in degree, with mild cases presenting late due to milder symptoms. More severe cases can have renal and respiratory failure from lung underdevelopment as result of low amniotic fluid volumes , requiring intensive care and close monitoring. It occurs in about one in 8,000 babies.
15-886: [REDACTED] Look up puv in Wiktionary, the free dictionary. PUV may refer to: Posterior urethral valve (PUV) Pulau virus (PuV) Public utility vehicle (PUV) for public transportation in the Philippines Publivoo (ICAO airline code PUV ), see List of airline codes (P) Malabou Airport (IATA airport code PUV ), Poum, Malabou, New Caledonia; see List of airports in New Caledonia See also [ edit ] [REDACTED] Search for "puv" on Misplaced Pages. PVU (disambiguation) puu (disambiguation) PVV (disambiguation) PW (disambiguation) Topics referred to by
30-510: A concept that has come from an in-depth analysis of the historical papers, and evaluation of patients with a prenatal diagnosis that has facilitated video recording of the uninstrumented obstructed urethra. The congenital obstructive lesions in the bulbar urethra, named Type III Valves by Young in 1919, have been eponymously referred to as Cobb's collar or Moorman's ring. For each of the COPUM (Posterior Urethra) and Cobb's (Bulbar Urethra) lesions,
45-406: A connection between the amniotic sac and the fetal bladder, or vesicoamniotic shunt. There are three specific endoscopic treatments of posterior urethral valves: The standard treatment is primary (transurethral) ablation of the valves. Urinary diversion is used in selected cases, and its benefit is disputed. Following surgery, the follow-up in patients with posterior urethral valve syndrome
60-535: A small camera is inserted into the urethra for direct visualization of the posteriorly positioned valve. A limitation of this technique is that posterior valve tissue is translucent and can be pushed against the wall of the urethra by inflowing irrigation fluid, making it difficult to visualize. Cystoscopy may also demonstrate the bladder changes. Centers in Europe and Japan have also had excellent results with cystosonography, although it has not been approved for use in
75-403: Is an important anatomic landmark for pathology in a congenital anomaly known as posterior urethral valves , in which there is a developmental obstruction of the urethra in newborn male infants. Urethral carcinoid tumors have been reported at the verumontanum. The structure tends to migrate caudally , or downward, in hypospadia disorders and is then seen in the bulbous, or penile portion of
90-431: Is characterized by an abrupt tapering of urethral caliber near the verumontanum , with the specific level depending on the developmental variant. Vesicoureteral reflux is also seen in over 50% of cases. Very often the posterior urethra maybe dilated thus making the abrupt narrowing more obvious. the bladder wall may show trabeculations or sacculations or even diverticuli. Diagnosis can also be made by cystoscopy , where
105-446: Is different from Wikidata All article disambiguation pages All disambiguation pages Posterior urethral valve PUV can be diagnosed before birth, or even at birth when the ultrasound shows that the male baby has a hydronephrosis. Some babies may also have oligohydramnios due to the urinary obstruction. The later presentation can be a urinary tract infection, diurnal enuresis, or voiding pain. Abdominal ultrasound
120-448: Is long term, and often requires a multidisciplinary effort between paediatric surgeons/ paediatric urologists , paediatric nephrologists, pulmonologists , neonatologists , radiologists and the family of the patient. Care must be taken to promote proper bladder compliance and renal function, as well as to monitor and treat the significant lung underdevelopment that can accompany the disorder. Definitive treatment may also be indicated for
135-413: Is of some benefit, but not diagnostic. Features that suggest posterior urethral valves are bilateral hydronephrosis, a thickened bladder wall with thickened smooth muscle trabeculations, and bladder diverticula . Voiding cystourethrogram (VCUG) is more specific for the diagnosis. Normal plicae circularis are variable in appearance and often not seen on normal VCUGs. PUV on voiding cystourethrogram
150-404: Is translated from Latin to mean 'mountain ridge', a reference to the distinctive median elevation of urothelium that characterizes the landmark on magnified views. Embryologically , it is derived from the uterovaginal primordium . The landmark is important in classification of several urethral developmental disorders. The margins of seminal colliculus are the following: The verumontanum
165-489: The United States yet. Posterior urethral obstruction was first classified by H. H. Young in 1919. The verumontanum , or mountain ridge, is a distinctive landmark in the prostatic urethra, important in the systemic division of posterior valve disorders: Dewan has suggested that obstruction in the posterior urethra is more appropriately termed congenital obstructions of the posterior urethral membrane (COPUMs),
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#1732791337764180-408: The degree of obstruction can be variable, consistent with a variable expression of the embryopathy. The now nearly one hundred year old nomenclature of posterior urethral valves was based on limited radiology and primitive endoscopy, thus a change COPUM or Cobb's has been appropriate. If suspected antenatally, a consultation with a paediatric surgeon/ paediatric urologist maybe indicated to evaluate
195-676: The risk and consider treatment options. The most important first treatment in a newborn baby boy is to relieve the bladder with urethral catheter or suprapubic drainage. Treatment is by endoscopic valve ablation. Fetal surgery is a high risk procedure reserved for cases with severe oligohydramnios , to try to limit the associated lung underdevelopment, or pulmonary hypoplasia , that is seen at birth in these patients. The risks of fetal surgery are significant and include limb entrapment, abdominal injury, and fetal or maternal death. Specific procedures for in utero intervention include infusions of amniotic fluid , serial bladder aspiration, and creating
210-403: The same term [REDACTED] This disambiguation page lists articles associated with the title PUV . If an internal link led you here, you may wish to change the link to point directly to the intended article. Retrieved from " https://en.wikipedia.org/w/index.php?title=PUV&oldid=1090966373 " Category : Disambiguation pages Hidden categories: Short description
225-449: The vesico-ureteral reflux. The female homolog to the male verumontanum from which the valves originate is the hymen . Verumontanum The seminal colliculus ( Latin colliculus seminalis ), or verumontanum , of the prostatic urethra is a landmark distal to the entrance of the ejaculatory ducts (on both sides, corresponding vas deferens and seminal vesicle feed into corresponding ejaculatory duct). Verumontanum
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