Obstructive uropathy in childhood, as seen in University of Port Harcourt Teaching Hospital, Nigeria

Abstract

Background: Obstructive uropathy is a cause of morbidity and mortality in children. In Port Harcourt, data on causes of obstructive uropathies are not readily available. This study was carried out to identify the causes and outcome of obstructive uropathies seen in our children's ward.

Methods: The case records of children with the diagnosis of obstructive uropathies who were treated at the University of Port Harcourt Teaching Hospital (UPTH) between October 1997 and October 2002 were reviewed.

Results: A total of 20 patients, all males were seen. The ages ranged from 4 weeks to 13 years with a mean of 2.3+/-2.8 years. The causes of obstructive uropathy were posterior urethral valves (PUV) 16 (80%), bladder calculi 2 (10%), bladder rhabdomyosarcoma and urethral stenosis 1 (5%) each. Poor stream of urine and dysuria were the commonest presentation. The duration of symptoms ranged from 2 days to 13 years. None of the patients with PUV was diagnosed prenatally. Hypertension and urinary tract infection each were found in 50% of the patients while 6 (30%) presented with features of renal failure. Seven patients died, giving a mortality rate of 35%. Age at presentation less than one year and duration of symptoms longer than one month was associated with higher mortality although it was not statistically significant.

Conclusion: PUV is the commonest cause of obstructive uropathy seen in UPTH. Earlier diagnosis during pre-natal period or when this is not possible, diagnosis within the first week of life should be encouraged. Parents, nurses and attending doctors should ensure they observe the urinary stream of every male child before discharge from the hospital for early detection and management of PUV.