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Does delayed presentation of posterior urethral valve carry worse prognosis?

Posterior urethral valve (PUV) is the most common cause of lower urinary tract obstruction in male neonates, with an incidence of 1 in 8000–25,000 live births. The clinical course of PUV diagnosed late in life is quite unpredictable. The prognosis of late-diagnosed PUV depends chiefly on the renal function at presentation. A literature search was performed on the delayed presentation of PUV. Serum creatinine at presentation, nadir serum creatinine (defined as the lowest creatinine attained in the year after valve ablation), and renal parenchymal echogenicity were significant predictors of final renal outcome. A generalization cannot be made regarding the prognosis of late-presenting PUV patients. The prognosis varies from case to case. If renal function at presentation and after valve ablation is preserved, then late-presenting PUVs carry good prognosis. Age per se does not carry any prognostic significance.