#1 Ranked Children’s Hospital by U.S. News & World Report
MyPatients provides referring primary care providers with secure access to their patients’ information.
Boston Children's has launched the world's 1st program dedicated to offering hand transplants to children who qualify.
Innovation insider is a semi-monthly e-newsletter analyzes innovations at Boston Children’s, other academic medical centers and from industry.
Read the latest blog by a Boston Children's doctor, clinician or staff member.
There are many ways you can help children and their families get the care they need.
At Boston Children's Hospital, we take a multidisciplinary approach to treating posterior urethra valves (PUV). From your first visit, you'll work with a team of specialists from various disciplines who are dedicated to helping your family find the best care for your child—when he is first diagnosed, throughout treatment and as he grows.
How is PUV treated?
In 95 percent of cases, PUV is treated with a surgical procedure called endoscopic incision of the valves
Emergency surgery may be used if your child has:
Although medication alone can't treat PUV, it may be used in addition to surgery to treat more severe problems.
For example, the wall of the bladder has two layers: a soft inner lining and an outer layer of muscle. Some boys have severe hyperactivity of that muscle, which makes the bladder muscle stiff. These boys may benefit from medications that help relax and soften the bladder muscle.
The most common classes of medication used to help relax the bladder muscle include:
How often do children with PUV need to be seen?
Ongoing medical management is very important for boys with PUV. Due to the varying degrees of severity, some boys will need to be followed more closely than others. For the most part, boys will need to be monitored for kidney function, bladder functioning and voiding ability (emptying of the bladder).
Generally, after the initial surgery is performed, a child will receive another voiding cystourethrogram (VCUG) to ensure that the appearance of the valves is gone or much less significant.
Six months after the valves have been ablated, doctors will continue to monitor the child's bladder function using a urodynamic study:
How might PUV affect my child's long-term health?
There could be some long-term problems, so it's important for your son's doctor to see him periodically.
Some of these problems could include:
Even after surgery, your son may continue to experience mild symptoms of urinary incontinence, frequency and urgency. A simple outpatient procedure can often cure these symptoms.
If your son's urinary tract is severely affected, extensive reconstructive surgery may be helpful in preventing damage to the kidneys.
It's essential that you keep in close contact with your son's physician so that she can monitor your son for any sign of developing problems.
Will my child be OK?
Most boys with PUV will have normal kidney function, normal bladder function and normal continence. In most cases, these boys will also be able to have normal sexual development and normal fertility.
Since boys have a 20-25% chance of kidney failure over the course of their lifetime, our specialists in Urology make maintaining optimal bladder function the primary goal of treatment. We help these boys throughout their lifetime with bladder function issues, incontinence and decreasing the risk of urinary tract infections (UTIs). This is done through urodynamic testing to objectively study the bladder function.
If you are feeling overwhelmed by your child's diagnosis of posterior urethral valves (PUV), remember that Children's is here to help. We're dedicated to helping families locate the information and resources they need to better understand their child's particular condition and take part in their care.
This list outlines some of our resources at Children's and in the wider community that may be helpful to you:
Resources for children and families:
Adolescence can be stressful time—even for physically healthy teens. Having a condition like PUV may present further difficulties for teenage boys.
We are grateful to have been ranked #1 on U.S. News & World Report's list of the best children's hospitals in the nation for the third year in a row, an honor we could not have achieved without the patients and families who inspire us to do our very best for them. Thanks to you, Boston Children's is a place where we can write the greatest children's stories ever told.”