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The first 25 slides, exactly as they appear. The full deck has 42 content slides.
Paediatric Surgery
Posterior Urethral Valves
Built from Puri — Pediatric Surgery and Pediatric Urology
What’s inside
5 sections · 42 slides
What the Problem Is
A blocked outflow in the male urethra, present from birth
- Roadmap: what this deck will teach you
- What is a posterior urethral valve?
- Why the obstruction damages everything upstream
- Posterior urethral valves by the numbers
- The four described types of valve
- The two obstructing types side by side
How It Presents and Is Diagnosed
From the sick newborn to the prenatal scan
- A wide spectrum, worst disease appears earliest
- Pop-off mechanisms: when a leak protects the kidney
- How older children present
- Emergency stabilization of the sick infant
- Finding valves before birth
- Confirming the diagnosis: the VCUG
Endoscopic Ablation
The minimally invasive treatment of choice
- Why endoscopic ablation is first choice
- Step 1: assess and calibrate the urethral caliber
- Step 2: delineate the anatomy
- Valves pushed open by irrigation on scope entry
- Valves billowing shut when irrigation is off
- Step 3: where to ablate the valve
- Ablation with the infant resectoscope
- Hooking the valve leaflet with the resectoscope loop
- Ablation with a Bugbee electrode
- Bugbee electrode ablation of the valve
- Ablation in tiny urethras and low-resource settings
- After ablation
Intervening Before Birth
Promise, risk, and the PLUTO trial
- The rationale for in-utero treatment
- What the PLUTO trial showed
- Selecting the rare candidate for fetal intervention
Outcomes and the Long Game
Bladder dysfunction, prognosis, and future tools
- What ablation achieves
- Valve bladder syndrome
- Managing bladder dysfunction
- Predicting who does well
- The future: predicting outcome before birth
- Key takeaways
- References (1/2)
- References (2/2)
- Pediatric Surgery and Pediatric Urology