Serving children and families with kidney disease for over 30 years
Normal Renal Anatomy
In the normal kidney blood is filtered, urine produced and then begins passage through the urinary collecting system.
Under normal circumstances the urine travels through the collecting system and into the bladder so that no urine is seen by ultrasound anywhere other than the bladder.
When we see urine in the other parts of the collecting system, this suggests that there is an abnormality somewhere in the collection system.
Posterior Urethral Valves (PUV)
A Posterior Urethral Valve is an extra flap of skin that develops in the back of the urethra obstructing the flow of urine out of the bladder.
The muscle of the bladder works harder to push the urine out and builds up high pressures that
Cause increased the thickness of the bladder wall
Cause reflux of urine from the bladder back into the kidney
Cause developmental injury to the kidney
Approach
Often seen on pre-natal ultrasound
Amniotic fluid levels are good indication of urine output from the bladder in utero
Kidney development, Urine output, and lung development are closely tied
The most important initial assessment at birth is breathing problems
At the time of birth urine output and urine stream are good clues about PUV
The best test for PUV is a Voiding CystoUrethrogram (VCUG)
This test will give information about PUV and reflux
If PUV are detected they usually require surgical resection shortly after birth
1425 Richard Arrington Jr Blvd So Birmingham, AL 35205-3841 Phone: (205) 558-3200 Fax: (205) 623-1090
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