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Posterior urethral valves with collecting system rupture: a single center experience

Background: Urine leakage of collecting system occurs as a result of lower urinary tract obstructions (LUTOs) like posterior urethral valves (PUVs). We report the short-term prognosis of PUV in infants with collecting system rupture by retrospective review of clinical data and patient follow-up. 
 Methods: Medical records from 2010 to 2018 in our center were reviewed, and clinical data of patient with PUV and collecting system rupture, as well as the current follow-up, were analyzed. 
 Results: A total of 10 infants met the criteria with an admission age from 7 days to 15.5 months. There are 6 cases with perinephric urinoma, 2 cases with urinary ascites, and 2 cases with both retroperitoneal urinoma and urinary ascites. In the first 4 cases, urinoma/ascites drainage was performed as the first surgery, but primary valve ablation or vesicostomy was performed in the later 6 cases. All the urinary leakages recovered well. The serum creatinine (SCr) at the last follow-up was 30.1±6.0 µmol/L compared to the initial value of 105.8±141.1 μmol/L. The total glomerular filtration rate (GFR) increased from an initial level of 49.95±15.96 to 70.49±14.83 mL/min during the follow-up. Conclusions: The recovery of renal function in the patients was satisfactory. Thus, good drainage of the collecting system might be the first choice in cases of PUV with collecting system rupture.