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Quick Case

Urethral Valve Disorder Compromises Kidney Development

Urethral-valve-disorder-compromises-kidney-development A boy born with posterior urethral valve disorder experienced chronic kidney disease and bladder dysfunction as a result of the prenatal effects of the blockage.

Immediately after birth, the child had undergone a procedure to clear the obstructive valve tissue—the first of 3 surgeries to help preserve residual kidney function and overall childhood development.

When the patient was 4 years of age, John S. Wiener, MD, Duke’s chief of pediatric urology, performed cutaneous vesicostomy to alleviate the deleterious effects of the abnormal bladder by allowing urine to spill freely onto the skin and into a diaper. The procedure temporarily arrested kidney decline.

Question: Recognizing the patient would eventually outgrow his damaged kidneys, what long-term care strategy did Duke pediatric nephrologists, urologists, and transplant surgeons use?

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