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Effects of posterior urethral valves on long-term bladder and sexual function

Nature Reviews Urology volume 9, pages 699–706 (2012)Cite this article

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Abstract

Bladder function is often compromised in juvenile patients with posterior urethral valves (PUV). In infancy, such abnormal bladder function is characterized by low compliance or overactivity, but later in life the bladder tends to become oversized and empties poorly. Polyuria, which is often associated with renal failure as well as secondary changes in the bladder neck, also has an effect on bladder function. Perhaps as a consequence of these contributing factors, toilet training is often delayed in children with PUV. Adults who were treated for PUV as a child tend to experience lower urinary tract symptoms at a rate twofold to threefold higher than healthy men. Furthermore, these adult patients with PUV might have risk factors for sexual and fertility dysfunctions later in life, such as cryptorchidism, renal failure and abnormal posterior urethra. However, despite the high incidence of these risk factors, sexual function and fertility seems to be normal in most patients.

Key Points

  • Typical bladder behaviour in patients with posterior urethral valves (PUV) changes from poorly compliant or overactive bladder in infancy to poorly emptying bladder in adolescence

  • Consequently, toilet training is often delayed in these children, which is a key feature of children with lower urinary tract symptoms (LUTS)

  • One-third of adults who were treated for PUV in childhood have moderate or severe LUTS, and the prevalence of LUTS is between twofold and threefold higher in these men than in the general population

  • Patients with PUV have several risk factors for sexual dysfunction, such as abnormal posterior urethra, cryptorchidism and renal failure

  • However, in adults who were treated for PUV, sexual function and fertility is generally normal and comparable to men in the general population

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Figure 1: Images of PUV.

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Authors and Affiliations

  1. Department of Paediatric Surgery, Children's Hospital, University of Helsinki, Stenbäckinkatu 11, Helsinki, 00290, Finland

    Seppo Taskinen & Risto Rintala

  2. Department of Paediatric Surgery, Hyvinkää Hospital, Sairaalankatu 1, Hyvinkää, 05850, Finland

    Jukka Heikkilä

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S. Taskinen researched the data and wrote the first draft of the article. J. Heikkilä and R. Rintala provided substantial contribution to the content and writing of the article. All authors reviewed and edited the manuscript before submission.

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Taskinen, S., Heikkilä, J. & Rintala, R. Effects of posterior urethral valves on long-term bladder and sexual function. Nat Rev Urol 9, 699–706 (2012). https://doi.org/10.1038/nrurol.2012.196

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