P U Valves-1 year male child with recent H/o febrile UTI

! year male child was referred from pediatrician with h/o febrile UTI before 2 weeks.

S. Creatinine- 0.44
S. electrolytes normal
Post AB therapy culture negative
His VCUG done before few days, posting for review.
Please discuss
On asking mother she told child is voiding with severe straining-how this history missed?
How will you treat this patient?

P U Valves-1 year male child with recent H/o febrile UTI


  • Dr. Aadil Farooq
    Dr. Aadil Farooq
    23 May 2020 05:33:57 AM


    A proper history and clinical examination along with spine, buttocks, genitalia and anal opening.

    Evaluation of upper tract with USG KUB with pvr.
    We can see the reflux on left side. 
    Next, plan for cystourethroscopy and fulgration of valves. 
    Leave catheter for 3-5 days.
    Send urine for protein and creatinine with PCR.
    Continue antibiotic prophylaxis. 
    Sincere Regards. 
    Please guide. 

  • Dr. Anil Takvani
    Dr. Anil Takvani
    24 May 2020 09:16:55 AM

    What is your choice 

    Smaller cystoscope and bugbi fulguration 
    Resectoscope and resect the valves 
    Cold cuts 
    Where will you cut /Fulgurate /resect? 
    What is your and your institutional experience? 
    Please discuss... Thanks 

  • Dr. Aadil Farooq
    Dr. Aadil Farooq
    25 May 2020 10:50:00 PM


    I am using both 9 Fr resectoscope
    as well pediatric compact (8/9.5 Fr) Cystoscope with bugbee.

    I fulgrate at 5,7 and often 12'o clock position with small burst of cutting current 20 watts.
    Catheterize the pt. for 3 days.

  • Rahul Kapoor
    Rahul Kapoor
    27 May 2020 11:18:10 PM

    Anyone has experience using Holmium laser. 

  • Ramesh Babu
    Ramesh Babu
    28 May 2020 03:47:41 PM

    Prefer 9-10F resectoscope with coldknife. Better control with resectoscope than bugbee. Cold knife less stricture rate. 

  • Dr. Anil Takvani
    Dr. Anil Takvani
    28 May 2020 05:35:57 PM

    Dear Dr. Ramesh Babu,

    Thanks for posting valuable comments.
    I would like to request you, if available, post video of valve ablation procedure-how you do..
    With that I am requesting all the participants to attach link to video clip of valve ablation procedure if you have...

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