Lower urinary obstruction in infancy. A review of lesions and symptoms in 165 cases.

This paper reviews 165 cases of lower urinary obstruction in infancy. The commonest lesions were posterior urethral valves (91) and ectopic ureterocele (34), stenosis or atresia of the urethra (8), and bladder neck obstruction (6). There were 12 different diagnoses in the remaining 26 cases. The commonest presenting features were general in nature (110), and of these, failure to thrive and vomiting (87) were most frequent. The commonest urinary signs and symptoms were palpable bladder (93) and urinary infection (90). An accurate diagnosis was obtained by intravenous pyelography or cystourethrography. Treatment was directed to correction of electrolyte and water disturbances, followed by early relief of the obstruction. The mortality rate was 32·5% for children admitted in the first month of life, and only 8% thereafter, with an overall rate of 18%.