scholarly journals A Rare Case of Urinary Ascites in Newborn

2016 ◽  
Vol 5 (1) ◽  
pp. 1098
Author(s):  
J. Singh ◽  
A. C. Khanna ◽  
S. Arora
Keyword(s):  
Urinary Tract ◽  
Newborn Infant ◽  
Rare Case ◽  
Posterior Urethral Valve ◽  
Bladder Rupture ◽  
Urinary Ascites ◽  
Ventilator Support ◽  
Common Cause ◽  
Urethral Valve

Urinary ascites in a newborn infant is unusual and most commonly indicates a disruption to the integrity of urinary tract, the most common cause being posterior urethral valve. The report describes a case of urinary ascites, probably calyx or bladder rupture due to underlying posterior urethral valve. The patient presented as an emergency and was treated with ventilator support and subsequent drainage of urine.

scholarly journals Urinary ascitis in neonate with posterior urethral valve

2018 ◽  
Vol 5 (5) ◽  
pp. 2023
Author(s):  
Sunny Malvia ◽  
Pradeep Meena ◽  
Suresh Goyal ◽  
Juhi Mehrotra ◽  
Ravi Rawat
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Obstruction ◽  
Imaging Techniques ◽  
Abdominal Distension ◽  
Posterior Urethral Valve ◽  
Male Child ◽  
Corrective Surgery ◽  
Urinary Ascites ◽  
Common Cause ◽  
Urethral Valve

Urinary ascites in a newborn infant is not very common. It indicates a disruption to the integrity of the urinary tract. Urinary tract obstruction leads to increased pressure which causes urine collection within the peri-renal spaces and subsequent urinary ascites either by calyceal perforation or filtration through the walls of urinary tract. Posterior urethral valve is most common cause of urinary tract obstruction in male child. The report describes a male child of age 17 days, presented with gross abdomen distension and diagnosed as urinary ascites, due to underlying posterior urethral valve. The abdominal distension was relieved with subsequent drainage of urine. Diagnosis was made using imaging techniques and corrective surgery planned.

scholarly journals Urinary Ascites and Transient Intestinal Obstruction in a Preterm Infant: An Interesting Case of Posterior Urethral Valve

2019 ◽  
Vol 09 (03) ◽  
pp. e209-e212
Author(s):  
S. Mani ◽  
F. Kupferman ◽  
K. Kumar ◽  
S. Hazra ◽  
M. Sokal ◽  
...  
Keyword(s):  
Intestinal Obstruction ◽  
Left Kidney ◽  
Outlet Obstruction ◽  
Posterior Urethral Valve ◽  
Interesting Case ◽  
Bladder Rupture ◽  
Voiding Cystourethrogram ◽  
Fetal Hydrops ◽  
Urinary Ascites ◽  
Urethral Valve

AbstractPosterior urethral valve (PUV) is the most common congenital cause of bladder outflow obstruction in male neonates. We report a preterm neonate with PUV who presented as nonimmune fetal hydrops with intestinal obstruction in the antenatal period. The mother of our patient is a 33-year-old woman who started her prenatal care at our hospital at 30 weeks' gestation. Her sonogram done at 32 weeks in our hospital revealed fetal hydrops. It showed polyhydramnios, mild pyelectasis of right kidney, normal left kidney, and fetal ascites. Amniocentesis revealed bile stained amniotic fluid. Ultrasound during the procedure showed dilated fetal bowel loops with increased echoes. Following delivery at 32 weeks postnatal exam showed ascites with absence of skin edema, pleural, or pericardial effusion. The abdominal sonogram showed distended urinary bladder and bilateral hydroureteronephrosis. Bladder catheterization was done which relieved the bladder outlet obstruction. Voiding cystourethrogram was done later which confirmed PUV and bilateral grade 5 vesicoureteral reflux. The formation of urinary ascites in PUV serves as a pop-off mechanism to relieve the intravesical and intrarenal pressure. When this happens by mechanisms other than bladder rupture, it can lead on to transient intestinal obstruction and hepatic synthetic defects.

scholarly journals Antenatally Diagnosed Posterior Urethral Valve: A Case Report

2016 ◽  
Vol 5 (1) ◽  
pp. 42-45
Author(s):  
Mahzabeen Islam ◽  
Masudur Rahman ◽  
Sankar Narayan Dey ◽  
Netay Kumer Sharma ◽  
Mir Naz Farzana
Keyword(s):  
Clinical Presentation ◽  
Antenatal Diagnosis ◽  
Late Onset ◽  
Obstructive Uropathy ◽  
Lower Abdominal Pain ◽  
Posterior Urethral Valve ◽  
Caesarian Section ◽  
Common Cause ◽  
Obstructive Lesion ◽  
Urethral Valve

Posterior urethral valve (PUV) are the most common congenital obstructive lesion of the urethra and a common cause of obstructive uropathy in infancy. Clinical presentation depends on the severity of the obstruction. In case of severe obstruction, the diagnosis is usually made antenatally. Here, we present a case of antenatally diagnosed PUV of a fetus of a lady in her 9th month of pregnancy with mild lower abdominal pain for several hours. On ultrasound (US) examination, we found 36.5±2 weeks of pregnancy with mild to moderate oligohydramnios. Fetal urinary bladder was over distended; both the kidneys were grossly hydronephrotic and PUV like echo lucent area was seen at the prostatic region (Key hole sign). Emergency caesarian section (CS) was done and US of the baby showed typical US finding of PUV. The prognosis of antenatal diagnosis of PUV in early pregnancy is poor. But in this case due to the late onset of symptoms and as immediate necessary steps were taken, the baby was totally cured. This case was reported to aware about importance of antenatal anomaly scan and to share our experience. CBMJ 2016 January: Vol. 05 No. 01 P: 42-45

scholarly journals Posterior urethral valve and anterior rectal duplication: a new combination

2019 ◽  
Vol 12 (7) ◽  
pp. e229648
Author(s):  
Kailas P Bhandarkar ◽  
Nordeen Bouhadiba ◽  
Massimo Garriboli
Keyword(s):  
Rare Case ◽  
Posterior Urethral Valve ◽  
Duplication Cyst ◽  
New Combination ◽  
Acute Renal Injury ◽  
Urinary Stream ◽  
Urethral Valve ◽  
Rectal Duplication ◽  
Laparoscopic Assisted

We present a rare case of association of anterior rectal duplication and posterior urethral valve (PUV). A term neonate with no antenatal concerns was admitted with urosepsis and acute renal injury at 18 days of age. History revealed a poor urinary stream and dribbling. After resuscitation and stabilisation, renal tract ultrasound and micturating cysto-urethrogram were performed. Cystourethroscopy showed PUV and a mass indenting the bladder posteriorly. MRI confirmed the presence of a cystic lesion anterior to the rectum suspicious of rectal duplication. Laparoscopic-assisted excision of the anterior rectal duplication cyst was then performed. The infant recovered uneventfully. Creatinine normalised postoperatively and has been stable at follow-up.

scholarly journals Outcomes of intrauterine interventions for the treatment in fetal urinary tract obstructions

2021 ◽  
Vol 11 (1) ◽  
pp. 7-13
Author(s):  
M Pavlichenko ◽  
N Kosovtsova ◽  
N Bashmakova
Keyword(s):  
Urinary Tract ◽  
Perinatal Outcomes ◽  
Posterior Urethral Valve ◽  
Upper Urinary Tract ◽  
Fetal Kidney ◽  
Original Shape ◽  
Mother And Child ◽  
Urethral Valve ◽  
Cavity System ◽  
Grade Iii

Introduction: The leading cause of chronic renal failure in newborns, which occurs soon after birth is obstructive uropathies. Objectives: To prove the effectiveness of nephroamniotic shunting based on the evaluation of perinatal outcomes of this procedure, as well as a comparative analysis of the use of the stent manufactured by "Cook" (Ireland), 3.0 Fr/100 mm and the stent “SDE–MED”, 3.0 Fr/50 mm with the original shape of pigtails. Methods: After checking the safety of the stent “SDE-MED”, 3.0 Fr/50 mm developed by FGBU Mother and Child Care Research Institute with the original shape of pigtails in an animal experiment, the stent was used in clinical practice for intrauterine shunting in cases of unilateral or bilateral hydronephrosis of grade III to IV and posterior urethral valve disorder. In the final part of the study, a comparison of the outcomes of nephroamniotic shunting using two different stents was made. Results: The “SDE–MED” 3.0 Fr/50 mm stent provided more effective fixation in the fetal kidney cavity system in comparison to the stent manufactured by “Cook” (Ireland) 3.0 Fr/100 mm. Conclusion: Intrauterine shunting surgery of the upper urinary tract is a pathogenetically justified method of treating urinary tract obstructions and can be used to correct all types of fetal renal obstructions.

scholarly journals Fetoscopic laser valve ablation in the posterior urethral valve case with intrauterine diagnosis

2020 ◽  
Vol 28 (3) ◽  
pp. 206-211
Author(s):  
Selahattin Kumru ◽  
Serdar Kaya
Keyword(s):  
Urinary Tract ◽  
Lower Urinary Tract ◽  
Urinary Tract Obstruction ◽  
Treatment Options ◽  
Posterior Urethral Valve ◽  
Fetal Ultrasonography ◽  
Lower Urinary Tract Obstruction ◽  
Urethral Valve ◽  
Lower Urinary

Objective: We aimed to present the procedure of intrauterine percutaneous fetoscopic laser valve ablation performed on a fetus diagnosed with lower urinary tract obstruction. Case(s): Bilateral hydroureteronephrosis, dilated bladder and oligo/ anhydramnios were found in the fetal ultrasonography examination of a 21-year-old pregnant woman who did not have regular follow-ups, and the lower urinary tract obstruction consistent with the posterior urethral valve was considered in the case. The patient who was found to have poor prognosis as a result of vesico synthesis carried out consecutively was informed about the follow-up and treatment options, and the posterior urethral valve ablation was performed by the percutaneous fetoscopic laser on 27 weeks of gestation. The amniotic fluid was at normal levels after the procedure, and the labor was carried out at term. The newborn with elevated postpartum creatinine was diagnosed with stage 2 renal failure, but dialysis was not required during the follow-ups. The newborn was discharged for outpatient follow-up upon the reduced creatinine levels. Conclusion: By taking the survival enhancing effect of the intrauterine intervention into account in the presence of lower urinary tract obstruction, we considered that intrauterine intervention can be an option in the cases who prefer to continue their pregnancies. The families should be informed in detail about the benefits and risks of intrauterine intervention to repair the obstruction.

scholarly journals Deciphering the Mutation Spectrum in South Indian Children With Congenital Anomalies of the Kidney and Urinary Tract

2021 ◽  
Author(s):  
Ambili Narikot ◽  
Varsha Chhotusing Pardeshi ◽  
Shubha AM ◽  
Arpana Iyengar ◽  
Anil Vasudevan
Keyword(s):  
Urinary Tract ◽  
Congenital Anomalies ◽  
Posterior Urethral Valve ◽  
Genetic Diagnostics ◽  
Genetic Profile ◽  
Fetal Life ◽  
Indian Children ◽  
South Indian ◽  
Dysplastic Kidney ◽  
Urethral Valve

Abstract Background: Congenital anomalies of the kidney and urinary tract (CAKUT) cover a spectrum of structural malformations that result from aberrant morphogenesis of kidney and urinary tract. It is the most prevalent cause of kidney failure in children. Hence, it is important from a clinical perspective to unravel the molecular etiology of kidney and urinary tract malformations. Causal variants in genes that direct various stages of development of kidney and urinary tract in fetal life have been identified in 5–20 % of CAKUT patients from Western countries. Recent advances in next generation sequencing technology and decreasing cost offer the opportunity to characterize the genetic burden of CAKUT in Indian population and facilitate integration of genetic diagnostics in care of children with CAKUT. Methods: Customized targeted panel sequencing was performed to identify mutations in 31 genes known to cause human CAKUT in 69 south Indian children with CAKUT. The NGS data was filtered using standardized pipeline and the variants were classified using ACMG criteria. Genotype and phenotype correlations were performed. Results: The cohort consisted of children mostly with posterior urethral valve (PUV) (39.1%), vesico-ureteric reflux (VUR) (33.3%) and multi-cystic dysplastic kidney (MCDK) (7.2%). Likely pathogenic variants were identified in two genes (TNXB and CHD1L) in 2 children (9 %) with CAKUT. One child diagnosed with posterior urethral valve (PUV) had mutation in two different genes [TNXB (p. Gln286fs), and CHD1L (p. Ser837fs)], while second child with left duplex system had a single gene mutation in TNXB gene (p. Gln286fs). Conclusions: The present study identified novel monogenic mutations in only a small proportion of patients with CAKUT using a targeted gene panel. The low prevalence of genetic cause may be due to higher proportion of children with abnormalities in lower urinary tract than hypodysplasia of kidneys. Clinical or whole exome sequencing may be a better method to characterize the genetic profile of Indians patients with CAKUT.

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