Posterior Urethral Valve
Posterior urethral valves (PUVs) are membranes that develops in the lower urinary tract and obstruct the posterior urethra. PUV has an incidence of 2.2 in 10,000 births, or nearly 900 cases annually in the United States. It only occurs in boys and may have a genetic component. In patients with PUV, the blockage of flow causes a buildup of urine in the bladder and vesicoureteral reflux (reverse flow). Up to 30% of children born with PUV progress to end-stage renal disease by adolescence, requiring dialysis and kidney transplant for survival. PUV patients also suffer from bladder and lung dysfunction, and they require extensive lifelong care.
Additionally, PUV reduces the amount of amniotic fluid, which can impair lung development. The current treatment, a vesicoamniotic shunt, is effective at restoring fluid but has a risk of dislodgement. If dislodgement occurs, the patient requires an additional surgery to insert a replacement shunt, and each repeat surgery is life-threatening. This risk is largely due to the incision into the amniotic sac, which can rupture the membrane and induce dangerously premature labor. The larger the incision, the greater the risk.
A research team is currently working on a novel way of restoring amniotic fluid with minimum risk to the fetus and the mother.