Congenital anterior urethral valves and diverticula: a rare disease with good prognosis

Authors

  • Abhiyutthan Singh Jadaon Department of Urology, ILBS, Hospital, New-Delhi, India
  • Chitra Champawat Department of Minimal Access Surgery, Kota Heart Hospital, Kota, Rajasthan, India
  • Chandra Pal Singh Department of Minimal Access Surgery, Kota Heart Hospital, Kota, Rajasthan, India

DOI:

https://doi.org/10.18203/2349-2902.isj20250817

Keywords:

Anterior urethral valve, Good prognosis, Fulguration, Excision

Abstract

Congenital anterior urethral valves (AUV) are rare congenital anomalies causing lower urinary tract obstruction in children. It can occur as an isolated entity or in association with proximal diverticula. We present our experience of congenital AUV. We did a retrospective review of the medical records From September 2017 to August 2018 to analyze the clinical presentation, investigations, treatment, and outcome of 7 cases of AUV. Two patients were diagnosed as isolated AUV while five presented with associated diverticula. The age of presentation ranged from 6 months to 3 years. Weak voiding stream, swelling on the ventral aspect of the penile urethra and dribbling were the most common symptoms. Renal function was found to be deranged in two patients (28%). Hydro-ureteronephrosis was present in two boys (28%). Post-void residual volume was >20 ml (mean 55 ml) in all children. Transurethral fulguration was carried out on isolated AUV. Open resection and reconstruction were performed in patients with AUV and proximal diverticula. Surgical outcome was successful in all patients except for occurrence of surgical site infection in one patient. We conclude that in isolated AUV transurethral ablation is the treatment of choice. Primary excision and repair are preferred if a diverticulum has formed. Eventual outcomes of AUV are good if irreversible changes have not been established.

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References

Naradimhan KL, Choudhary SK, Kaur B. Anterior urethral valves. Indian Pediatr 2005;42:708-10.

Burstein JD, Firlit CF. Anterior urethra. In: Kelalis PP, King LR, Belman AB, editors. Clinical Pediatric Urology. Philadelphia: PA, WB Saunders. 1985: 558-61.

Firlit RS, Firlit CF, King LR. Obstructing anterior urethral valves in children. J Urol 1978;119:819-21. DOI: https://doi.org/10.1016/S0022-5347(17)57642-9

Kusuda L, Sakti D. Anterior urethral valves. A case report. Scand J Urol Nephrol 1989;23:231-3. DOI: https://doi.org/10.3109/00365598909180848

Khim A, Harris RD, Raffel J. Anterior urethral valve presenting in an adult male. Urol Radiol. 1991;12:196-8. DOI: https://doi.org/10.1007/BF02924007

Gupta DK etal.Concealed anterior urethral diverticulum in a child. IJU. 2000;16:160-1. DOI: https://doi.org/10.4103/0970-1591.22221

Punekar SV. J Postgrad Med. 1995;41:46-47. DOI: https://doi.org/10.1108/eb051380

Aygun C, Guven O, Tekin MI, Peskircioglu L, Ozkardes H. Anterior urethral valve as a cause of end stage renal disease. Int J Urol. 2001;8:141-3. DOI: https://doi.org/10.1046/j.1442-2042.2001.00270.x

Watts SH. Urethral diverticulum in male with report of a case. Johns Hopkins Hosp Rep 1906:13:48-89.

Castle AJ. Posterior urethra valves and other urethral anomalies. 9th ed. Campbell Walsh Urology. 2007: 3600.

Williams DI, Retik AB. Congenital valves and diverticula of the anterior urethra. Br J Urol. 1969;41:228-30. DOI: https://doi.org/10.1111/j.1464-410X.1969.tb09928.x

Karnak I, Senocak ME, Büyükpamukçu N, Hiçsönmez A. Rare congenital abnormalities of the anterior urethra. Pediatr Surg Int. 1997;12:407-9. DOI: https://doi.org/10.1007/BF01076951

Brueziere J, Delmont P. Deux cas de diverticule sacciforme de l’ure`tre ante´rieur. J Urol Nephrol. 1971;77:772-8.

Boissonnat P, Duhamel B. Congenital diverticulum of the anterior urethra associated with aplasia of the abdominal muscles in a male infant. Br J Urol. 1962;34:59-69. DOI: https://doi.org/10.1111/j.1464-410X.1962.tb11663.x

Paulhac P, Fourcade L, Lesaux N, Alain JL, Colombeau P. Anterior urethral valves and diverticula. BJU Int. 2003;92:506-9. DOI: https://doi.org/10.1046/j.1464-410X.2003.04380.x

Van Savage JG, Khoury AE, McLoury GA, Bagli DJ. An algorithm for management of anterior urethral valves. J Urol. 1997;158:1030-2. DOI: https://doi.org/10.1016/S0022-5347(01)64381-7

Firlit CF. Urethral abnormalities. Urol Clin North Am. 1978;5:31-5. DOI: https://doi.org/10.1016/S0094-0143(21)00018-5

Glazier DB, Underberg SJ, Cummings KB. Neonatal bladder rupture due to anterior urethral valves. Br J Urol 1997;80:819-20. DOI: https://doi.org/10.1046/j.1464-410X.1997.00317.x

Zia-ul-Miraj M. Anterior urethral valves: a rare cause of infravesical obstruction in children. J Pediatr Surg 2000;35:556-8. DOI: https://doi.org/10.1053/jpsu.2000.0350556

Yaxley RP. Congenital valves of the anterior urethra. Med J Aust. 1969;2:295-7. DOI: https://doi.org/10.5694/j.1326-5377.1969.tb105729.x

Golimbu M, Orca M, Al-Askari S, Morales P, Golimbu C. Anterior urethral valves. Urol. 1978;12:343-6. DOI: https://doi.org/10.1016/0090-4295(78)90403-X

Kaplan GW, Scherz HC. Anterior urethral valves. In: Kelalis PP, King LR, Belman AB, editors. Clinical pediatric urology. 3rd ed. Philadelphia, PA: Saunders; 1992: 851-3.

Huang CJ, Bai JW, Liang RX, Sun N. Congenital anterior urethral valves and diverticula-analysis of 50 cases. Ann Acad Med Singapore. 1989;18:665-8.

Gupta DK, Srinivas M. Congenital anterior urethral diverticulum in children. Pediatr Surg Int. 2000:16:565-8. DOI: https://doi.org/10.1007/s003830000430

Rushton HG, Parrott TS, Woodard JR. The role of vesicostomy in the management of anterior urethral valves in neonates and infants. J Urol. 19871;38:107-9. DOI: https://doi.org/10.1016/S0022-5347(17)43008-4

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Published

2025-03-26

How to Cite

Jadaon, A. S., Champawat, C., & Singh, C. P. (2025). Congenital anterior urethral valves and diverticula: a rare disease with good prognosis . International Surgery Journal, 12(4), 575–579. https://doi.org/10.18203/2349-2902.isj20250817

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Case Series