The importance of second look cystoscopy in children with PUV and its impact on future bladder, kidney functions and fertility

This study was designed to assess the importance of second look cystoscopy after primary ablation of posterior urethral valve in children. A prospective study was conducted at Kasr Al Ainy Pediatric Hospital (Aboulreesh), Urology Department, Cairo University on 50 male children, diagnosed to have posterior urethral valve between September 2016 and June 2017. Diagnosis of posterior urethral valve was made by voiding symptoms, ultrasonography and confirmed by voiding cystourethrogram. All children were treated by endoscopic ablation of posterior urethral valve using cold knife and were followed clinically for voiding symptoms and with ultrasonography and laboratory tests. All patients underwent 2nd look cystoscopy one month after primary valve ablation to see residual valves as a routine procedure irrespective of the improvement in symptoms, ultrasonography or laboratory results. Mean age at presentation was 8.3 ± 12.6 months. The presenting symptoms were acute urine retention in (44%); obstructive symptoms in (42%), recurrent febrile UTI in (10%) and two patients (4%) underwent primary valve ablation based on antenatal diagnosis. 92% showed hydronephrosis at presentation. Serum creatinine was elevated in 72% at presentation. Residual valves on 2nd look cystoscopy were found in 60%.&nbsp