Description

ABSTRACT

Background: Posterior Urethral Valves (PUV) are the most common cause of bladder outlet obstruction in infancy that impair renal and bladder function. Endoscopic PUV ablation is however not commonly practiced in our country compared to valve avulsion using the catheter balloon. Objective: This study was planned to establish the use of hysteroscopic scissors in incising the posterior urethral valves endoscopically via a paediatric size cystoscope in the absence of a bugbee electrode. Patients and methods: This study was a prospective study of endoscopic posterior urethral valve treatments carried out in Colworths Medical Centre between November 2013 and April 2016. All the patients had a check cystoscopy with a 6.5fr cystoscope under mild sedation and local instillation of 1% lignocaine jelly. Information obtained includes age, diagnosis, procedure, duration of surgery, complications and were analysed. Results: During the period of study, 13 babies who were diagnosed with PUV following clinical and radiological evaluations had the endoscopic valve treatment using the hysteroscopic scissors to incise the valve at 5 and 7 O’clock positions. Ten patients had good stream at immediate post operative period and disappearance of the valve after micturating cystourethrogram. Two babies had recurrence and needed a second surgery resulting in good urinary stream with post-operative Micturating Cystourethrogram (MCU) showing complete disappearance of the valve. One child had post operative sepsis and required a suprapubic cystostomy. Conclusion: Endoscopic posterior valve excision using hysteroscopic scissors is a safe procedure and is regularly performed in Port Harcourt, Nigeria. This obviates the need for a diathermy using bugbee electrode and result is very satisfactory.

 Keywords: Endoscopic, Hysteroscopic scissors, Endoscopic, Micturating Cystourethrogram (MCU)